EN
TÜRKÇE
Poster - 202
Virtual Reality as a Distraction Tool During K-wire Removal in Children: Results from a Randomized Controlled Trial
Kathrin Kelly 1, Juliane Pretzsch 2, Lena Altenburger 2, Alexander Tzabazis 3, Judith Lindert 4, Reinhard Vonthein 5, Ludger Tüshaus 2
1 Department of Thoracic surgery, Lungenclinic Großhansdorf, Germany
2 Department of Paediatric Surgery, University Lübeck
3 Department of Anesthesiology, Intensive Care and Rescue and Pain Medicine, BG Klinikum Hamburg
4 Department of Paediatric Surgery, University Rostock
5 Institute of Medical Biometry and Statistics, University of Lübeck
Purpose:
Pain and anxiety during minor yet distressing procedures remain a challenge in the childrens hospital. Our study, which was completed in 2024 and published just recently, consists of a three-year prospective randomized controlled trial evaluating the efficacy of virtual reality (VR) distraction tools in reducing pain and influencing procedural memory in children undergoing percutaneous Kirschner-wire removal after osteosynthesis of wrist and elbow fractures.
Methods:
In the outpatient fracture clinic of our department of pediatric surgery, 146 children aged 4–16 years were randomized to receive either standard care or immersive VR distraction during K-wire removal. Stratification was performed by age. Pain and anxiety were assessed using the Wong-Baker Faces Pain Rating Scale, FLACC Scale, and mYPAS Scale, reported by neutral observers, patients, and guardians. Objective physiological markers such as heart rate variability and blood pressure were also recorded. Follow-up questionnaires assessed the children's recollection and emotional memory of the procedure immediately and two weeks post-intervention.
Results:
Children in the VR group reported significantly lower pain scores on the Wong-Baker scale (OR 0.225; 95% CI 0.12–0.43). Observer-rated pain >2 was noted in 43% of VR cases vs. 74% in controls. Reductions were also seen in FLACC (OR 0.364) and mYPAS (OR 0.285) scores. The VR group retained less negative procedural memory both immediately and two weeks post-procedure, indicating a lasting positive effect on emotional recall.
Conclusion:
Virtual reality is a powerful and effective tool for reducing procedural pain and anxiety in pediatric patients undergoing K-wire removal. Moreover, its positive influence on procedural memory highlights its potential in improving long-term patient experience in pediatric surgical care.