Please confirm that an ethics committee approval has been applied for or granted: Not relevant

Background and Aims Gaming in virtual reality (VR) is regarded as a secure and efficient substitute for traditional pain management techniques. The usefulness and practicability of a VR game for frequent burn dressing changes were examined in our study.

Methods A randomized clinical trial was conducted among burned children hospitalized in the pediatric surgery department. We included burned children aged 4 to 12 years requiring daily dressing changes for at least 10 days a week. . One group played an interactive VR game during the dressing change, while children in the other group had a dressing change every other day while sedated with Ketamine and Propofol for 10 days. Perceived pain was assessed using a numerical rating scale (NRS) from 0 to 10 for both groups and the satisfaction of parents and care givers was also assessed.

Results 18 children were recruited for this study. The majority were male (2/1 ratio) with second-degree burns (91.4%). Children and caregivers in the VR group reported less pain from the 4th dressing change onwards. Children in the VR group reported a clinically significant (≥23%) reduction in overall pain, and the caregiver described no incidents or difficulties with dressing changes compared to subjects in the control group. Parent satisfaction with VR remained at high level during dressing changes over the 1-week period, with reported realism and engagement increasing over time. More than half of the children (54.5%) enjoyed playing the game and no difficulties.

Conclusions VR should be considered as a nonpharmacologic companion for pain management during burn dressing changes