Effects of Virtual Reality Distraction on Pain, Stress, and Heart Rate during Pediatric Ingrown Toenail Surgery: A Randomized Controlled Trial

jpedsurg.org

Immersive virtual reality (VR) shows efficacy in reducing pediatric procedural pain and stress, yet studies remain heterogeneous and conflate stress with anxiety while neglecting physiological measures such as heart rate (HR). The role of goal-directed attention remains underexplored, as no studies have controlled for VR-interactivity to isolate its contribution under clinically relevant conditions. Thus, this RCT investigates the effects of goal-directed VR vs. free-interaction VR vs. standard-of-care (SoC) distraction (controls) on self-reported pain, stress, and HR during ingrown toenail surgery under local anesthesia in children and adolescents

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Article · Sep 2025 · 1 min read

In brief

This randomized controlled trial examines whether immersive virtual reality reduces pain, stress, and heart rate in children undergoing ingrown toenail surgery with local anesthesia. The study compares goal-directed VR, free-interaction VR, and standard distraction techniques, addressing gaps in understanding VR interactivity's role in pediatric procedural pain control.

Immersive VR effectively reduces pediatric procedural pain and stress during minor surgery under local anesthesia.
Goal-directed VR attention may offer distinct benefits over passive VR interaction for pain management in children.
Heart rate provides objective physiological data complementing self-reported pain and stress measures in pediatric procedures.
Current VR studies conflate stress with anxiety; this trial distinguishes these constructs with validated measures.
VR interactivity level (goal-directed vs free-interaction) is a critical variable requiring controlled investigation.

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