Virtual Reality Reduces Pain Scores and Anxiety: November 2025, Narrative Review Highlights

These findings are published in November 2025, in Trends in Anaesthesia and Critical Care.

The Clinical Challenge of Postoperative Recovery

Postoperative pain is a primary concern for patients, directly impacting recovery, satisfaction, and rehabilitation. Despite medical advances, 30–80% of patients report severe pain on their first day following surgery. The medical community faces a central challenge: providing effective relief without the risks associated with opioids, such as Persistent Postoperative Use (PPOU). In England, opioid-related hospitalizations cost the National Health Service (NHS) £137 million over a ten-year period. Safety concerns were recently highlighted by the Medicines and Healthcare Regulatory Agency (MHRA), which advised against using certain modified-release opioid preparations for postoperative relief.

Review Overview

The narrative review synthesized evidence from 2013 to 2024 across major databases, including PubMed, Embase, and the Cochrane Library. The analysis focused on the efficacy and mechanisms of immersive Virtual Reality (VR), which creates an artificial three-dimensional (3D) environment through a Head-Mounted Display (HMD). The effectiveness of the experience relies on three foundational pillars: immersion, interaction, and presence. The review included randomized controlled trials (RCTs), observational studies, and meta-analyses involving both pediatric and adult populations.

The key findings from the review include:

• A meta-analysis of 723 surgical patients showed significant analgesic benefits in both major and minor surgeries, including dental, orthopedic, and gynecological procedures.

• In pediatric populations, VR sessions resulted in statistically significant reductions in pain intensity and anxiety immediately following treatment, as measured via the Numeric Rating Scale (NRS).

• Neuroimaging via Functional Magnetic Resonance Imaging (fMRI) demonstrated that VR modulates the Anterior Cingulate Cortex (ACC) and the Primary and Secondary Somatosensory Cortices (SS1 and SS2), effectively reducing pain-related brain activity.

• While generally safe, cybersickness (nausea or dizziness) occurs in at least one-third of users, suggesting a need for standardized session durations of 15–20 minutes.

Clinical Relevance and Future Integration

For healthcare providers, the study suggests that VR offers a promising, low-risk strategy for opioid sparing. Economic models indicate that VR is cost-effective if it achieves a reduction in opioid use of at least 2.8% at discharge, calculated using the quality-adjusted life year. (QALY) metric. To ensure safety, clinical pathways should include staff training and infection control, such as using hospital-grade wipes between users. Future research must focus on determining the optimal environment design and long-term functional outcomes, such as those seen in Phantom Limb Pain (PLP) rehabilitation.

Reference

ttia M, Wilson A, Hughes-Noehrer L, Collinson S, Rogers SK, Abdelghani M, McGrath B, Bowling FL, Kitchen G. Virtual reality for postoperative pain relief: A narrative review. Trends in Anaesthesia and Critical Care. 2026;66:101618