Enhancing Patient Experience in the Emergency Department: The Role of Virtual Reality in Laceration Repair

Virtual reality (VR) has emerged as a non-pharmacologic adjunct for procedural pain and anxiety in acute care, yet its specific value during laceration repair in the emergency department (ED) remains variably characterized. We conducted a focused synthesis of randomized and controlled studies captured in a pre- curated dataset, isolating trials that evaluated VR during sutured laceration repair while contextualizing ED venipuncture/IV studies to appraise feasibility and workflow considerations. Across five laceration- focused trials (N=582; two pediatric, three adult), VR was consistently feasible and well-tolerated, and in several studies reduced pain and/or anxiety during suturing. Pediatric trials reported lower procedural pain and fear, decreased need for physical holding, and very high willingness to reuse VR; adult trials demonstrated sizable anxiety reductions and favorable physiologic correlates, though one study found no advantage for head-mounted VR over standard screen-based distraction. Safety signals were benign, with only transient cybersickness reported and no serious adverse events attributable to VR. Additional ED evidence from venipuncture/IV trials (N=520) showed comparable first-attempt success rates and acceptance by staff and families, while signaling that VR can add several minutes to procedure duration depending on implementation. Collectively, these data suggest VR can improve patient experience during ED laceration repair, particularly in children, without compromising procedural success. Heterogeneity in study design, outcome measures, and blinding, as well as limited long-term follow-up, constrain definitive comparative conclusions. Standardized outcome frameworks, explicit reporting of analgesic/holding requirements, head-to-head comparisons against other distraction modalities, and cost- utility analyses are needed to guide scalable, equitable adoption in diverse ED environments.