Letter to the Editor regarding “Effects of vertical reality distraction on pain, stress, and heart rate during ingrown toenail surgery”

jpedsurg.org

The recent trial by Felnhofer et al. raises important questions about the role of virtual reality (VR) in pediatric surgery [1]. Their results show that not all VR approaches are equally effective, and unguided VR may even increase pain perception. This suggests VR should be understood as more than a distraction.

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Article · Oct 2025 · 1 min read

In brief

This letter critiques a VR distraction study in pediatric ingrown toenail surgery, highlighting that unguided VR may paradoxically increase pain perception. The authors argue VR effectiveness depends on implementation approach and should not be viewed merely as passive distraction.

Not all VR approaches are equally effective for pain management in pediatric surgery.
Unguided VR may paradoxically increase pain perception rather than reduce it.
VR should be understood as more than simple distraction—implementation strategy matters.
Felnhofer et al. trial highlights need for evidence-based VR protocols in pediatric procedures.
Effective VR interventions likely require structured guidance rather than passive immersion.

Written by the GCMD Library team from the article.

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