Background: To evaluate the effectiveness of virtual reality (VR) devices with different immersion levels on procedure-related pain in children through network meta-analysis.Methods: We systematically searched multiple databases for randomized controlled trials comparing VR interventions versus standard care for managing needle-based procedural pain in children.Traditional pairwise and network meta-analyses were performed.Results: Nineteen studies (2042 participants) were included.VR devices effectively reduced procedural pain.Network meta-analysis (11 studies, 1362 participants) revealed: non-immersive VR performed best for Wong-Baker FACES scores, fully immersive VR for Face, Legs, Activity, Cry, Consolability (FLACC) scores, and semi-immersive VR ranked second for Children's Face Scale outcomes.Overall, semi-immersive VR demonstrated superior effectiveness across all pain measures.Conclusions: Semi-immersive VR showed the best overall therapeutic effect.We recommend semi-immersive VR as the preferred intervention for managing procedure-related pain in pediatric clinical practice.Practice implications: These findings provide evidence-based guidance for clinical technology selection.Semiimmersive VR offers a practical, cost-effective, non-pharmacological intervention for outpatient and inpatient settings.Implementation should incorporate standardized operator training, 5-7 min immersion duration, and scenario activation 30 s pre-procedure.
Shi et al. (Thu,) studied this question.