Virtual Reality for Managing Procedural Pain and Distress in Paediatrics: A Scoping Review

BACKGROUND: Procedural pain and distress in children can result in severe short- and long-term consequences, including post-traumatic stress syndrome and needle phobia. While distraction techniques (e.g., toys, music) have been widely used, virtual reality (VR) offers a novel, immersive form of distraction. Despite the rapid development of VR technologies, there is a lack of comprehensive evidence regarding which paediatric patients and procedures benefit most from VR interventions. METHODS: We conducted a scoping review following the PRISMA-ScR guidelines. A systematic search across PubMed, Embase, Web of Science, Cochrane Library and Chinese databases (CNKI, Wanfang, VIP, SinoMed) identified studies from January 1, 2000 to November 15, 2025. Inclusion criteria were randomized controlled trials (RCTs) or quasi-experimental designs assessing VR for pain/anxiety management during medical procedures in paediatric patients, with outcomes including pain intensity, distress, feasibility, satisfaction or safety. RESULTS: Of the 5458 original database citations, 201 were eligible for full-text evaluation. Of these articles, a total of 22 were included in the scoping review. RCTs comprised 81.8% (n = 18). The majority (86.4%) employed immersive VR and 27.3% utilized cost-effective smartphone-based systems. Procedures targeted included venipuncture, needle-related interventions, intravenous access, surgery and burn wound care. Approximately 86.4% of studies reported VR's superiority over standard care in reducing procedural pain and distress. CONCLUSION: VR is an effective, non-pharmacological tool for managing procedural pain and distress in paediatric clinical settings, showing promise for integration into routine care. However, existing studies exhibit methodological heterogeneity and focus primarily on short-term outcomes. Future research should prioritize large-scale, rigorously designed RCTs with long-term follow-up, and focus on developing standardized, evidence-based VR protocols for diverse paediatric populations. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution was required for this scoping review, as it only synthesized existing published literature without primary data collection.