Original article available at https://www.chla.org/virtual-reality-pediatrics
An anxious adolescent showed up to have his blood drawn and was asked if he’d like to try virtual reality goggles. The boy agreed. A few minutes later he asked, “When are you going to take it?” According to Jeffrey I. Gold, PhD, the boy was surprised when he removed his headset and found that the blood sample had already been drawn and was on the table beside him.
In pediatric facilities throughout the country, children undergo necessary yet painful and distressing procedures every day, but very few non-pharmaceutical interventions have been determined to successfully manage the pain and anxiety associated with these procedures. To date, few clinical trials have been conducted to thoroughly study the effectiveness of these interventions.
Gold, a clinical psychologist and director of the Pediatric Pain Management Clinic in the Department of Anesthesiology Critical Care Medicine at Children’s Hospital Los Angeles, has embarked on a new study to examine the effectiveness of virtual reality (VR) for children and adolescents undergoing painful procedures such as blood draws.
He and a team of researchers have hypothesized that patients using VR will report significantly less procedural pain and anticipatory anxiety, as well as lower heart rates and less behavioral distress, than patients receiving the standard of care, such as topical anesthetics.
“Pain is not simple,” says Gold. “Most people think pain is just about tissue damage, but the pain system is really a very complex and sophisticated network of signals cascading across many regions of the brain. It is an integrated chemical, physiological and behavioral response.
AppliedVR, a software solutions company, is supplying specialized headsets for the study and working with Gold to design and develop content for the virtual reality experience. Gold, who is also a professor of Anesthesiology, Pediatrics, and Psychiatry and Behavioral Sciences at the Keck School of Medicine of the University of Southern California (USC), explains that not everything produced for VR is valid for managing pain. “We’re testing an ‘environment’ here that’s being developed especially for the purposes of pain management.”
Immersive VR allows the user to become an active participant in a virtual world as it captures the visual, auditory and tactile senses, as well as the limbic sense of emotion. “When someone is fully engaged and immersed in a VR experience, they are releasing endorphins,” he says. “These endorphins can produce an opioid response that markedly reduces the patient’s subjective pain.”
Given the significant concerns about problematic opioid use in the U.S., Gold is hopeful that evidence-based support for non-pharmaceutical interventions such as VR may lead to improved procedural pain management and a decreased need for narcotics.
“While it has not yet been extensively tested in a pediatric population, preliminary evidence suggests that VR may be particularly effective for pain management among children and adolescents,” he says. It’s also safer and a lot more fun.