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needles, pain, pediatric, virtual reality



  1. Pestana-Santos, Marcia PhD(c)
  2. Santos, Daniela BSc
  3. Pinto, Jessica BSc
  4. Nunes, Sara BSc
  5. Lomba, Lurdes PhD


Introduction: Needle procedures can be very painful for children and generate stress and anxiety. Virtual reality (VR) has been used to enhance a child's distraction for pain control during these procedures. This study aims to identify the advantages and limitations of VR used for pain control in procedures using needles in pediatrics.


Methods: Studies were limited to children aged 4-18 years undergoing a procedure involving needles and the use of VR with goggles, headset, or helmet. A comprehensive search strategy using CINAHL Complete, MedicLatina, Medline Complete, B-on, LILACS, and SciELO databases was undertaken to find relevant studies published from January 2015 to April 2020. The retained studies included experimental and quasi-experimental, randomized controlled trials and nonrandomized controlled trials as well as prospective and retrospective studies.


Results: The search yielded 80 articles. Of these, six articles met the inclusion criteria. Advantages found with the use of VR were (a) decrease of pain; (b) improvement of communication; (c) increased probability of success in performing the procedures; (d) reduction of anxiety, stress, distress, and fear; (e) easier handling of equipment; (f) almost complete isolation of external noise; and (g) low cost, lightness, and ease of transportation. Disadvantages reported were goggles' size and annoyance from repeated play and the occasional side effect of nausea.


Discussion: VR is considered an interactive digital therapeutic toy used with positive effects in clinical practice. As children become calmer, VR can also reduce nursing stress and improve communication between children and nurses.