• Michelle Gates, Lisa Hartling, Jocelyn Shulhan-Kilroy, Tara MacGregor, Samantha Guitard, Aireen Wingert, Robin Featherstone, Ben Vandermeer, Naveen Poonai, Janeva Kircher, Shirley Perry, GrahamTimothy A DTADEmergency Medicine, Faculty of Medicine and Dentistry.Alberta Health Services Edmonton Zone, Edmonton, Canada; and., Shannon D Scott, and Samina Ali.
• Department of Pediatrics and.
• Pediatrics. 2020 Feb 1; 145 (2).

ContextDigital distraction is being integrated into pediatric pain care, but its efficacy is currently unknown.ObjectiveTo determine the effect of digital technology distraction on pain and distress in children experiencing acutely painful conditions or procedures.Data SourcesMedline, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Institute of Electrical and Electronics Engineers Xplore, Ei Compendex, Web of Science, and gray literature sources.Study SelectionQuantitative studies of digital technology distraction for acutely painful conditions or procedures in children.Data ExtractionPerformed by 1 reviewer with verification. Outcomes were child pain and distress.ResultsThere were 106 studies (n = 7820) that reported on digital technology distractors (eg, virtual reality and video games) used during common procedures (eg, venipuncture, dental, and burn treatments). No studies reported on painful conditions. For painful procedures, digital distraction resulted in a modest but clinically important reduction in self-reported pain (standardized mean difference [SMD] -0.48; 95% confidence interval [CI] -0.66 to -0.29; 46 randomized controlled trials [RCTs]; n = 3200), observer-reported pain (SMD -0.68; 95% CI -0.91 to -0.45; 17 RCTs; n = 1199), behavioral pain (SMD -0.57; 95% CI -0.94 to -0.19; 19 RCTs; n = 1173), self-reported distress (SMD -0.49; 95% CI -0.70 to -0.27; 19 RCTs; n = 1818), observer-reported distress (SMD -0.47; 95% CI -0.77 to -0.17; 10 RCTs; n = 826), and behavioral distress (SMD -0.35; 95% CI -0.59 to -0.12; 17 RCTs; n = 1264) compared with usual care.LimitationsFew studies directly compared different distractors or provided subgroup data to inform applicability.ConclusionsDigital distraction provides modest pain and distress reduction for children undergoing painful procedures; its superiority over nondigital distractors is not established. Context, preferences, and availability should inform the choice of distractor.Copyright © 2020 by the American Academy of Pediatrics.

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