Effectiveness of Valsalva Maneuver on Pain among Patients Undergoing Peripheral Intravenous Cannulation

Mahmoud, Heba Mohammed; Mosaad, Shaymaa Elsayed; Elghareeb, Shimaa Mohamed

doi:10.21608/ejhc.2021.201916

Cited by 2 publications

(3 citation statements)

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“…37 Also, some patients were asked to hold their breath after a deep breath (glottis closed). 24,[38][39][40] Other investigations also referred only to VM and did not mention the details of the intervention. 30,41 All 12 articles reported pain intensity as their outcome.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…25,41 Changes in heart rate were reported in three studies, 33,34,40 variation in mean arterial pressure in two studies, 34,40 changes in systolic and diastolic BP in one study, 33 variation in SpO 2 level in one study, 34 and anxiety in two studies (Table 2). 38,39…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Two studies examined anxiety before and after VM in the intervention and control groups. 38,39 Numerical scales scored between 0 and 10 were used to measure anxiety. The results showed that VM reduced anxiety by 1.95, which was not statistically significant (Table 2).…”

Section: Anxietymentioning

confidence: 99%

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The effects of Valsalva maneuver on pain intensity and hemodynamic status during short peripheral cannula insertion in adults: A systematic review and meta-analysis

et al. 2022

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This systematic review and meta-analysis aimed to summarize the randomized clinical trial studies regarding the effects of Valsalva maneuver on the severity of short peripheral cannula insertion pain and hemodynamic status in adults. A systematic search was conducted on PubMed, Web of Science, Scopus databases, Cochrane, ClinicalTrials.gov, and Google Scholar Search Engine using keywords extracted from Medical Subject Headings, such as “Valsalva Maneuver,” “Valsalva’s Maneuver,” “Forced Expiratory,” “Balloon Inflation,” “Pain,” “Ache,” “Cannulation,” “Peripheral Intravenous Cannulation,” “Peripheral Catheterization,” “Vascular Access,” “Venous Cannulation,” “Venous Catheterization,” and “Catheterization,” from the inception to January 1, 2022. Finally, 12 and 11 articles were included in the qualitative and quantitative analysis of this systematic review and meta-analysis, respectively. Overall, pain intensity based on both the Numeric Rating Scale and Visual Analog Scale resulted in a large clinical effect (Effect Size: −1.20, 95% Confidence Interval: −1.69 to −0.71, p < 0.001). A large clinical effect was observed in a separate study of both scales because clinical effect has been determined in studies based on the Numeric Rating Scale (Effect Size: −1.26, 95% Confidence Interval: −1.90 to −0.62, p < 0.001 (and Visual Analog Scale (Effect Size: −1.09, 95% Confidence Interval: −1.98 to −0.20, p = 0.016). Valsalva maneuver significantly increased the mean heart rate (Weighted Mean Difference: 1.90, 95% Confidence Interval: 1.56–2.24, p < 0.001), decreased the mean arterial pressure (Weighted Mean Difference: 0.73, 95% Confidence Interval: −0.13 to 1.60, p = 0.096), and caused a non-significant decrease in anxiety (Weighted Mean Difference: −1.95, 95% Confidence Interval: −5.24 to 1.34, p = 0.25). The results showed that Valsalva maneuver significantly reduced pain intensity. Therefore, it is recommended that nurses use it as a convenient and low-cost non-pharmacological intervention to alleviate the severity of pain in non-cardiac patients. Also, it is suggested to conduct the studies with a strong methodological design and consider its effects on hemodynamic parameters in future investigations.

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Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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The effects of Valsalva maneuver on pain intensity and hemodynamic status during short peripheral cannula insertion in adults: A systematic review and meta-analysis

et al. 2022

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Efficacy and safety of the Valsalva maneuver in relieving venipuncture pain in children and adults: A systematic review and meta-analysis

Shi,

Li,

Huang

et al. 2024

J Vasc Access

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Venipuncture is a common invasive clinical procedure, and pain management during puncture has been of interest to healthcare professionals. The purpose of this systematic review and meta-analysis was to evaluate the efficacy and safety of the Valsalva maneuver (VM) for the relief of venipuncture pain in children and adults. PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, VIP database, and CBM were searched from inception to December 2023 for all available randomized controlled trials (RCTs) that evaluated the impact of VM on venipuncture. Two reviewers independently performed study selection, data extraction, and risk of bias assessment. Continuous variables were analyzed by mean differences (MD) or standardized mean differences (SMD), whereas dichotomous variables were analyzed by risk ratios (RR). A total of 22 studies involving 1740 participants were included. The pooled results showed that VM relieved pain intensity during venipuncture in children (SMD = −0.89, 95% CI = −1.47 to −0.30, p = 0.003) and adults (SMD = −1.11, 95% CI = −1.46 to −0.77, p < 0.00001), reduced anxiety intensity (SMD = −1.07, 95% CI = −1.68 to −0.47, p = 0.0005), and shortened puncture time (MD = −13.52, 95% CI = −21.14 to −5.90, p = 0.0005). There was no significant difference in the success rate of venous cannulation, MAP, HR, or incidence of adverse events in subjects who performed VM compared to controls. VM was an effective and safe method of pain management that reduced pain intensity during venipuncture in children and adults without significant adverse effects. The results of this meta-analysis need to be further validated by more rigorous and larger RCTs.

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Effectiveness of Valsalva Maneuver on Pain among Patients Undergoing Peripheral Intravenous Cannulation

Cited by 2 publications

References 1 publication

The effects of Valsalva maneuver on pain intensity and hemodynamic status during short peripheral cannula insertion in adults: A systematic review and meta-analysis

The effects of Valsalva maneuver on pain intensity and hemodynamic status during short peripheral cannula insertion in adults: A systematic review and meta-analysis

Efficacy and safety of the Valsalva maneuver in relieving venipuncture pain in children and adults: A systematic review and meta-analysis

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