Virtual Reality as Distraction Analgesia and Anxiolysis for Pediatric Otolaryngology Procedures

Objectives/Hypothesis While virtual reality (VR) has been used as analgesia and anxiolysis for invasive procedures, no literature exists on the use of VR in the pediatric otolaryngology setting. The purpose of this study was to determine the efficacy of VR in reducing pain and anxiety for pediatric otolaryngology patients. Methods A total of 53 patients aged 7-17 undergoing in-office nasal endoscopies were included. Patients were randomized to receive VR or standard of care. Procedural pain, anxiety, and satisfaction scores were recorded from patients and caregivers. The physician filled out a childhood emotional manifestation scale (CEMS). Study Design Randomized controlled trial. Results Patients in VR group reported a significant decrease in pain (0.80 +/- 1.06 vs. 2.26 +/- 2.38,P= .018) and anxiety (9.50 +/- 12.48 vs. 38.48 +/- 29.83,P= .0002) and increase in procedural satisfaction (6.40 +/- 0.77 vs. 4.74 +/- 1.74,P= .0002) compared to patients in control group. CEMS scores were significantly reduced in VR group (5.15 +/- 0.46 vs. 9.64 +/- 5.66,P= .0001) and caregiver anxiety levels were significantly reduced in VR group (11.50 +/- 17.67 vs. 27.39 +/- 30.48,P= .041) compared to control group. There were no reported side effects. Procedural time did not significantly differ between groups. Conclusions For pediatric otolaryngology patients undergoing in-office nasal endoscopies, VR is a safe and effective form of distraction analgesia and anxiolysis, significantly reducing pain and increasing procedural satisfaction for patients. In addition, VR significantly reduces anxiety for both patients and caregivers without disrupting procedural efficiency and workflow. Level of Evidence 2.Laryngoscope, 2020