Evidence and publications on anxiety and pain
Understanding the evidence in its clinical context
Explore the pathwayUnderstanding the evidence in its clinical context
Research on procedural VR examines pain, anxiety, tolerability and feasibility in different settings. Interpreting a result requires consideration of the population, device, content, comparator treatment and methods of measurement. Studies using other systems contribute to the rationale for use, but do not automatically validate REALICA in every specialty.
Pain and anxiety during blood sampling
Gold and Mahrer conducted a randomised study of VR during paediatric blood sampling. Compared with standard care, they found a reduction in procedural pain and anxiety. The study is relevant to distraction during needle procedures and should be read in the context of the system and population studied. [1]
Paediatric vascular access
Sanna and colleagues assessed the feasibility of virtual sedation during PICC placement in selected paediatric patients. The exploratory design is useful for discussing organisation and patient selection. It does not demonstrate that VR can replace pharmacological sedation in all cases. [2]
Study using REALICA
The study [3] uses REALICA VR. It is described on the Dentistry and paediatric dentistry subpage, together with its results and limitations.
Which conclusions are appropriate
The evidence supports clinical interest in immersive distraction and encourages its assessment within defined pathways. It does not justify promises of pain-free procedures, elimination of medication or guaranteed procedural success. Enjoyment and satisfaction must also be distinguished from clinical outcomes.
The bibliography provides an opportunity to examine the methods, populations and results of the cited studies in greater depth. Links to the original publications allow professionals to assess the relevance of the evidence to their own clinical setting.
Reference
publications.
Open the studies and consult the full references.
Gold and Mahrer
Gold JI, Mahrer NE. Is Virtual Reality Ready for Prime Time in the Medical Space? A Randomized Control Trial of Pediatric Virtual Reality… J Pediatr Psychol. 2018;43(3):266–275.
Source type: randomised study of VR during paediatric blood sampling. Evidence on the intervention modality; not a study of REALICA.
Read the original sourceSanna and colleagues
Sanna G, Camporesi A, Diotto V, Abbiati G, Torri A, Gemma M. Virtual sedation as a substitute to pharmacological sedation during PICC placement in pediatric patients: A feasibility study. J Vasc Access. 2024;25(1):313–317. Published online in 2022.
Source type: feasibility study. Evidence on VR and paediatric vascular access.
Read the original sourceFallea and colleagues
Fallea A, Treccarichi S, L’Episcopo S, et al. Virtual Reality Versus Monitor-Based Distraction in Children with Mild Intellectual Disability: A Preliminary Comparative Observational Study. Children (Basel). 2026;13(3):437.
Source type: prospective, comparative, non-randomised observational study using REALICA VR. Link to the full text:
Read the original sourceView the publications
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