{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T12:55:01Z","timestamp":1790168101266,"version":"4.1.0"},"reference-count":42,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Ineffective postoperative pain management affects more than 25% of hospitalized children, leading to increased morbidity, impaired physical function, delayed recovery, prolonged opioid use, and heightened health care costs. Traditional pharmacological interventions have limitations, particularly given growing concerns over long-term opioid use in pediatric populations. Virtual reality (VR) has emerged as a promising nonpharmacological intervention for pediatric pain management, offering immersive, multisensory experiences that can effectively distract and engage patients\u2019 attention away from pain sensations. This viewpoint examines the current evidence and prospects for VR as a component of pediatric multimodal pain management strategies. Several VR modalities have shown potential for reducing pain and anxiety in pediatric populations, including virtual reality\u2013distraction therapy, virtual reality\u2013exposure therapy, virtual reality\u2013guided relaxation\u2013based therapy, and virtual reality\u2013biofeedback therapy. The neurobiological underpinnings of VR\u2019s analgesic effects involve multiple mechanisms: the gate control theory explains how intense multisensory VR inputs compete with pain signal transmission, while the attention-modulation pathways involving the anterior cingulate cortex and periaqueductal gray work alongside emotional regulation pathways through amygdala connections to reduce pain perception. Recent studies involving various pediatric surgical populations have demonstrated VR\u2019s potential to reduce postoperative pain intensity, pain unpleasantness, anxiety, and in some cases, the need for rescue analgesia. However, VR\u2019s analgesic effects appear to be transient, typically lasting 15-30 minutes, which suggests the need for optimization in timing and frequency of VR sessions. Implementation challenges include cost considerations, technological access disparities, logistical requirements for safe use and storage, and staff training needs. As hospitals and health care systems continue to explore nonpharmacological pain management strategies, VR represents a promising adjunct to traditional approaches, potentially reducing reliance on opioid medications while improving patient experience and outcomes. Throughout this viewpoint, we address the major concepts related to VR, the use of VR in differing clinical situations, various VR-based therapy methods, and the practicality of VR to alleviate pain, as well as several key findings to date and future directions.<\/jats:p>","DOI":"10.2196\/68348","type":"journal-article","created":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T06:25:09Z","timestamp":1745389509000},"page":"e68348-e68348","source":"Crossref","is-referenced-by-count":9,"title":["Virtual Reality for Pediatric Postoperative Pain Management: Exploring Methods and Efficacy"],"prefix":"10.2196","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0817-537X","authenticated-orcid":false,"given":"Sidhant","family":"Kalsotra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5165-7245","authenticated-orcid":false,"given":"Dillon","family":"Froass","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6423-0374","authenticated-orcid":false,"given":"Aneesha","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1256-2476","authenticated-orcid":false,"given":"Sebastian","family":"Amaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0550-6951","authenticated-orcid":false,"given":"Joseph D","family":"Tobias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9110-0282","authenticated-orcid":false,"given":"Vanessa A","family":"Olbrecht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,8,7]]},"reference":[{"issue":"5","key":"R1","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1016\/j.jpainsymman.2005.09.003","article-title":"Pediatric pain prevalence and parents\u2019 attitudes at a cancer hospital in Jordan","volume":"31","author":"Forgeron","journal-title":"J Pain Symptom Manage"},{"issue":"1","key":"R2","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1155\/2008\/478102","article-title":"Pain in hospitalized children: a prospective cross-sectional survey of pain prevalence, intensity, assessment and management in a Canadian pediatric teaching hospital","volume":"13","author":"Taylor","journal-title":"Pain Res Manag"},{"issue":"1","key":"R3","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/S0304-3959(96)03163-6","article-title":"Prevalence and source of pain in pediatric inpatients","volume":"68","author":"Cummings","journal-title":"Pain"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S144066","article-title":"Poorly controlled postoperative pain: prevalence, consequences, and prevention","volume":"10","author":"Gan","journal-title":"J Pain Res"},{"issue":"1","key":"R5","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.pmn.2012.04.003","article-title":"Pain prevalence, intensity, assessment and management in a hospitalized pediatric population","volume":"15","author":"Kozlowski","journal-title":"Pain Manag Nurs"},{"issue":"1","key":"R6","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-2439","article-title":"Persistent opioid use among pediatric patients after surgery","volume":"141","author":"Harbaugh","journal-title":"Pediatrics"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S40846","article-title":"Identification of pain-related psychological risk factors for the development and maintenance of pediatric chronic postsurgical pain","volume":"6","author":"Pag\u00e9","journal-title":"J Pain Res"},{"issue":"9","key":"R8","doi-asserted-by":"publisher","first-page":"1700","DOI":"10.1016\/j.jpedsurg.2011.03.074","article-title":"Acute to chronic postoperative pain in children: preliminary findings","volume":"46","author":"Fortier","journal-title":"J Pediatr Surg"},{"issue":"6","key":"R9","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1016\/j.jpain.2017.03.007","article-title":"Prevalence and predictors of chronic postsurgical pain in children: a systematic review and meta-analysis","volume":"18","author":"Rabbitts","journal-title":"J Pain"},{"issue":"3","key":"R10","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1111\/pan.12327","article-title":"Effective postoperative pain management in children after ambulatory surgery, with a focus on tonsillectomy: barriers and possible solutions","volume":"24","author":"Dorkham","journal-title":"Paediatr Anaesth"},{"issue":"11","key":"R11","doi-asserted-by":"publisher","first-page":"2383","DOI":"10.1097\/j.pain.0000000000000281","article-title":"Trajectories of postsurgical pain in children: risk factors and impact of late pain recovery on long-term health outcomes after major surgery","volume":"156","author":"Rabbitts","journal-title":"Pain"},{"issue":"4","key":"R12","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1016\/j.jpain.2016.11.001","article-title":"The initiation of chronic opioids: a survey of chronic pain patients","volume":"18","author":"Callinan","journal-title":"J Pain"},{"issue":"2 Suppl","key":"R13","first-page":"S63","volume":"11","author":"Manchikanti","journal-title":"Pain Physician"},{"issue":"3","key":"R14","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1016\/j.jopan.2021.04.015","article-title":"The effects of designing an educational animation movie in virtual reality on preoperative fear and postoperative pain in pediatric patients: a randomized controlled trial","volume":"37","author":"Yaz","journal-title":"J Perianesth Nurs"},{"issue":"11","key":"R15","doi-asserted-by":"publisher","first-page":"2426","DOI":"10.1093\/pm\/pnab209","article-title":"Transient reductions in postoperative pain and anxiety with the use of virtual reality in children","volume":"22","author":"Olbrecht","journal-title":"Pain Med"},{"issue":"4","key":"R16","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1016\/j.jpurol.2021.04.008","article-title":"The effect of virtual reality on children\u2019s anxiety, fear, and pain levels before circumcision","volume":"17","author":"Buyuk","journal-title":"J Pediatr Urol"},{"issue":"10","key":"R17","doi-asserted-by":"publisher","first-page":"728","DOI":"10.1097\/EJA.0000000000001059","article-title":"Virtual reality exposure before elective day care surgery to reduce anxiety and pain in children: a randomised controlled trial","volume":"36","author":"Eijlers","journal-title":"Eur J Anaesthesiol"},{"issue":"7","key":"R18","doi-asserted-by":"publisher","DOI":"10.2196\/26328","article-title":"Guided relaxation-based virtual reality for acute postoperative pain and anxiety in a pediatric population: pilot observational study","volume":"23","author":"Olbrecht","journal-title":"J Med Internet Res"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.1016\/j.dib.2023.109331","article-title":"Dataset used to refine a treatment protocol of a biofeedback-based virtual reality intervention for pain and anxiety in children and adolescents undergoing surgery","volume":"49","author":"Orgil","journal-title":"Data Brief"},{"issue":"4","key":"R20","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1089\/cpb.2007.9993","article-title":"The neurobiology of virtual reality pain attenuation","volume":"10","author":"Gold","journal-title":"Cyberpsychol Behav"},{"issue":"6","key":"R21","doi-asserted-by":"publisher","first-page":"1776","DOI":"10.1213\/01.ane.0000270205.45146.db","article-title":"The analgesic effects of opioids and immersive virtual reality distraction: evidence from subjective and functional brain imaging assessments","volume":"105","author":"Hoffman","journal-title":"Anesth Analg"},{"issue":"2","key":"R22","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1093\/brain\/awf022","article-title":"Imaging how attention modulates pain in humans using functional MRI","volume":"125","author":"Bantick","journal-title":"Brain (Bacau)"},{"issue":"8","key":"R23","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1097\/01.wnr.0000127826.73576.91","article-title":"Modulation of thermal pain-related brain activity with virtual reality: evidence from fMRI","volume":"15","author":"Hoffman","journal-title":"Neuroreport"},{"issue":"1","key":"R24","doi-asserted-by":"publisher","DOI":"10.2196\/mental.7387","article-title":"Virtual reality for management of pain in hospitalized patients: results of a controlled trial","volume":"4","author":"Tashjian","journal-title":"JMIR Ment Health"},{"key":"R25","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001286","article-title":"Chronic pain as embodied defence: implications for current and future psychological treatments","volume":"159 Suppl 1","author":"Eccleston","journal-title":"Pain"},{"issue":"8","key":"R26","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0219115","article-title":"Virtual reality for management of pain in hospitalized patients: a randomized comparative effectiveness trial","volume":"14","author":"Spiegel","journal-title":"PLoS ONE"},{"issue":"4","key":"R27","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1177\/00031348211032204","article-title":"Virtual reality after surgery-a method to decrease pain after surgery in pediatric patients","volume":"89","author":"Specht","journal-title":"Am Surg"},{"issue":"6","key":"R28","doi-asserted-by":"publisher","first-page":"389","DOI":"10.17796\/1053-4625-45.6.5","article-title":"Immersive and non-immersive virtual reality distraction on pain perception to intraoral injections","volume":"45","author":"Kumari","journal-title":"J Clin Pediatr Dent"},{"key":"R29","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.737351","article-title":"Tips for effective implementation of virtual reality exposure therapy in phobias-a systematic review","volume":"12","author":"Krzystanek","journal-title":"Front Psychiatry"},{"issue":"12","key":"R30","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-040295","article-title":"Guided relaxation-based virtual reality versus distraction-based virtual reality or passive control for postoperative pain management in children and adolescents undergoing Nuss repair of pectus excavatum: protocol for a prospective, randomised, controlled trial (FOREVR Peds trial)","volume":"10","author":"Olbrecht","journal-title":"BMJ Open"},{"issue":"1","key":"R31","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-071274","article-title":"Feasibility and acceptability of perioperative application of biofeedback-based virtual reality versus active control for pain and anxiety in children and adolescents undergoing surgery: protocol for a pilot randomised controlled trial","volume":"13","author":"Orgil","journal-title":"BMJ Open"},{"key":"R32","doi-asserted-by":"publisher","DOI":"10.3389\/fpain.2023.1094125","article-title":"The role of virtual reality as adjunctive therapy to spinal cord stimulation in chronic pain: a feasible concept?","volume":"4","author":"Noble","journal-title":"Front Pain Res"},{"issue":"1","key":"R33","doi-asserted-by":"publisher","DOI":"10.1186\/s43058-023-00442-2","article-title":"Implementation of virtual reality in healthcare: a scoping review on the implementation process of virtual reality in various healthcare settings","volume":"4","author":"Kouijzer","journal-title":"Implement Sci Commun"},{"issue":"6","key":"R34","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1089\/cyber.2014.0058","article-title":"Feasibility of articulated arm mounted Oculus Rift virtual reality goggles for adjunctive pain control during occupational therapy in pediatric burn patients","volume":"17","author":"Hoffman","journal-title":"Cyberpsychol Behav Soc Netw"},{"issue":"2","key":"R35","doi-asserted-by":"publisher","DOI":"10.2196\/medinform.7271","article-title":"Virtual reality as an adjunct home therapy in chronic pain management: an exploratory study","volume":"5","author":"Garrett","journal-title":"JMIR Med Inform"},{"issue":"9","key":"R36","doi-asserted-by":"publisher","first-page":"3867","DOI":"10.1016\/j.ajtr.2017.09.015","article-title":"Application of virtual reality technology in clinical medicine","volume":"9","author":"Li","journal-title":"Am J Transl Res"},{"issue":"3","key":"R37","doi-asserted-by":"publisher","first-page":"197","DOI":"10.2217\/pmt.15.6","article-title":"The promise and challenge of virtual gaming technologies for chronic pain: the case of graded exposure for low back pain","volume":"5","author":"Trost","journal-title":"Pain Manag"},{"key":"R38","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2020.08.033","article-title":"Effects of virtual reality on relieving postoperative pain in surgical patients: a systematic review and meta-analysis","volume":"82","author":"Ding","journal-title":"Int J Surg"},{"issue":"1","key":"R39","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2024.2311846","article-title":"A multicenter feasibility randomized controlled trial using a virtual reality application of pain neuroscience education for adults with chronic low back pain","volume":"56","author":"McConnell","journal-title":"Ann Med"},{"issue":"2","key":"R40","doi-asserted-by":"publisher","first-page":"20552173211006139","DOI":"10.1177\/20552173211006139","article-title":"Virtual reality is a feasible intervention platform in multiple sclerosis: a pilot protocol and acute improvements in affect","volume":"7","author":"Shaw","journal-title":"Mult Scler J Exp Transl Clin"},{"issue":"7","key":"R41","doi-asserted-by":"publisher","DOI":"10.3390\/children4070052","article-title":"Immersive virtual reality for pediatric pain","volume":"4","author":"Won","journal-title":"Children (Basel)"},{"issue":"9","key":"R42","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1097\/AJP.0000000000000599","article-title":"Virtual reality as a distraction intervention to relieve pain and distress during medical procedures: a comprehensive literature review","volume":"34","author":"Indovina","journal-title":"Clin J Pain"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jmir.org\/2025\/1\/e68348","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:55:04Z","timestamp":1782842104000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2025\/1\/e68348"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,7]]},"references-count":42,"URL":"https:\/\/doi.org\/10.2196\/68348","relation":{},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,7]]},"article-number":"v27i5e68348"}}