Abstract Background/Aims There is a growing body of data highlighting the effectiveness of using virtual reality (VR) headsets as a distraction during painful procedures. This includes reports of reduced pain and anxiety during procedures. In the current context of climate change, it would be prudent to reduce the use of nitrous oxide, as it is a greenhouse gas that contributes to global warming. We introduced the option of use of a VR headset for intra-articular injections on the day unit instead of or alongside nitrous oxide for patients with juvenile idiopathic arthritis (JIA). Methods VR headset use was offered on an ad hoc basis to any patient highlighted by the team as appropriate or to any patient with a medical contraindication for nitrous oxide. The introduction of VR headset use for steroid joint injections was evaluated using a patient/parent/staff questionnaire and analysis of joint injection list data. Qualitative data were collected, reflecting patient/parent experience when using VR headsets and reasons for declining VR headset trial. Results Patients who chose to use the VR headset varied from age 7 to 15 years, often using cold spray or numbing cream to the injection site. Some patients used both VR headset and nitrous oxide; these were usually patients who had used nitrous oxide for joint injections in the past. Reasons patients refused VR included motion sickness, procedural anxiety, inability to see surroundings and successful previous experience with nitrous oxide. Feedback from those who used VR included multiple positive comments, such as “it was better with VR as I could focus on the game”. Patients often responded “yes” when asked if the VR headset was helpful and that they would recommend the use of VR headsets for painful procedures. Some patients who had previously had joint injections with nitrous oxide reported that it was better with the VR headset. Conclusion VR headsets have provided some benefit for our patient cohort and allowed some patients with contraindications for nitrous oxide to have joint injections awake, removing the need for general anaesthetic. While they are not appropriate for all patients, they have given us an additional tool to assist patients with their procedure. Disclosure L. Paterson-Brown: Other; Conference attendance funded by Novartis. M. Cox: None. N. Nicholson: None. M. Browne: None. A. Armstrong: None. J. Walsh: None. A. Shah: None. N. Martin: Other; Conference attendance funded by Novartis.
Paterson-Brown et al. (2026) studied this question.