594 - Virtual Reality Goggles During Venipuncture: Effective Anxiety Reduction in Pediatric Patients

Publication Number: 2579.594

Sophie Hurewitz, Drexel University College of Medicine, Philadelphia, PA, United States; Bailey Fink, Albert Einstein College of Medicine, West Hempstead, NY, United States; Katherine O'Connor, Albert Einstein College of Medicine, Bronx, NY, United States; Courtney McNamara, The Children's Hospital at Montefiore, Ossining, NY, United States

Background: Venipuncture is one of the most commonly performed procedures in hospitalized pediatric patients and a common source of general distress, pain, and anxiety. Emerging research has shown improvement to anxiety and pain scores in children receiving virtual reality (VR) immersion during venipuncture, however this has not yet been demonstrated in conjunction with the use of topical lidocaine prilocaine (EMLA).

Objective: This study assessed the effect of VR on pre- and post-venipuncture anxiety and pain scores for hospitalized pediatric patients between the ages of 5-21 years.

Design/Methods: This IRB approved study is a prospective, randomized, non-blinded, control trial with a sample of patients 5-21 years old admitted to an urban tertiary care children’s hospital. Patients with significant barriers to communication (i.e. severe intellectual disability, language other than English, Spanish, or Arabic), those with interfering neurologic conditions, and those who did not receive topical EMLA anesthetic prior to venipuncture were excluded. Patients were randomized to wear VR or not during venipuncture. VR consisted of an interactive underwater game with headset and remote control. Anxiety/pain questionnaires were completed before/after venipuncture (Visual Analogue Scale & Wong-Baker FACES Scale). The change in pre- and post-procedure anxiety/pain scores were calculated using a one-tailed t-test as we anticipated that VR would decrease anxiety/pain. VR and Control Group characteristics were evaluated using t-test (continuous variables) and chi square (categorical).

Results: Sample included 82 patients (Control Group n=43) enrolled between June 2021-July 2025. Results reveal a statistically significant difference between VR and Control Group patients in change in anxiety (p=0.042). VR Group patients reported an average decrease in anxiety of -7.82 points (SD=28.97, 95% CI=-17.21-1.57) and Control Group patients reported an average increase in anxiety of +2.21 points (SD=22.76, 95% CI= -4.80-9.22). Results reveal no significant difference between VR and Control Group patients in change in pain (p=0.385).

Conclusion(s): Results reveal that, even with EMLA, VR is effective at reducing anxiety. A unique feature of this study was the application of EMLA prior to venipuncture, which may have impacted statistical power in determining whether or not VR goggles effectively reduce venipuncture-associated pain in this patient population. Study findings are of important clinical utility and provide support for the goal of targeting VR intervention specifically to pediatric patients with anxiety when on a busy inpatient unit.