Virtual reality as an analgesic for acute and chronic pain in adults: a systematic review and meta-analysis.

Previous studies have shown that virtual reality (VR) is effective in reducing acute and chronic pain both in adults and in children. Given the emergence of new VR technology, and the growing body of research surrounding VR and pain management, an updated systematic review is warranted. The purpose of this systematic review is to compare the effectiveness of VR in reducing acute and chronic pain in adults. A search was conducted in three databases (PubMed, CINAHL, Trip) using standardized search terms. Twenty experimental and quasi-experimental trials published between January 2007 and December 2018 were included based on prespecified inclusion and exclusion criteria. Pain intensity was the primary outcome. We extracted data and appraised the quality of articles using either the PEDro or Modified Downs and Black risk of bias tools. The majority of studies supported the use of VR to reduce acute pain both during the procedure and immediately after. Numerous studies found VR reduced chronic pain during VR exposure but there is insufficient evidence to support lasting analgesia. There was considerable variability in patient population, pain condition and dosage of VR exposure. Due to heterogeneity, we were unable to perform meta-analyses for all study populations and pain conditions. VR is an effective treatment for reducing acute pain. There is some research that suggests VR can reduce chronic pain during the intervention; however, more evidence is needed to conclude that VR is effective for lasting reductions in chronic pain.