Volume 30, Issue 108 (October 2017)                   IJN 2017, 30(108): 52-59 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Babaei M, Jalali R, Jalali A, Rezaaei M. The Effect of Valsalva Maneuver on Pain Intensity and Hemodynamic Changes during Intravenous (IV) Cannulation. IJN 2017; 30 (108) :52-59
URL: http://ijn.iums.ac.ir/article-1-2517-en.html
1- Master of Critical Care Nurse, Kermanshah university of Medical Sciences, Kermanshah, Iran
2- Associate professor, Department of Nursing, School of Nursing and Midwifery, Kermanshah university of Medical Sciences, Kermanshah, Iran. (*Corresponding auther) Tel:09181324821 Email: KS_ jalali@yahoo.com
3- Assistant professor, Psychiatric Nursing Department, School of Nursing and Midwifery, Kermanshah university of Medical Sciences, Kermanshah, Iran
4- Associate professor, Department of Biostatistics and Epidemiology, Health School, Kermanshah university of Medical Sciences, Kermanshah, Iran
Abstract:   (10996 Views)
Background & Aims: Venous cannulation is a painful and stressful methodin health care sitting that various medical and non pharmacological methods are used in to reduce its pain. This study was conducted to investigate the effect of Valsalva maneuver on pain intensity and hemodynamic changes during IV cannulation.
Materials & Methods: In a clinical trial, 80 patients scheduled for elective surgery who were admitted to surgical wards,in Hazrat Rasol (Javanroud 2016) were studied. Convenience Sampling was used and assignment to two groups was randomly. In Valsalva group (blowing the plastic tube connected to a mercury sphygmomanometer and raising the mercury column up to 20 mm Hg for at least 20 seconds) 39 patients and 38 patients in control group (usual procedure) cannula was inserted on the back of the non-dominant hand. The pain intensity was measured by a Numerical Rating Scale (NRS). Hemodynamic responses to pain were measured by controlling blood pressure, heart rate and arterial blood oxygen saturation five minutes before and immediately after cannulation. The data was analyzed with chi-square tests, ANOVA, Tukey, Kruskal-Wallis and Mann-Whitney tests using SPSS software (version 16).
Results: The Mean NRS in Valsalva group was 2/75 ± 1095 and in control group was 4.86 ± 2.30, which showed a significant decrease in pain severity (P≤0.05) The heart rate decreased from (80.53 ± 14.71) to (77 ± 13.36) after cannulation in the control group (P≤0/05). While other hemodynamic variables did not show significant difference.
Conclusion: The Valsalva maneuver is a non-pharmacological method that can be easily performed and reduces cannulation pain without making hemodynamic changes.
Full-Text [PDF 661 kb]   (1894 Downloads)    
Type of Study: Research | Subject: nursing
Received: 2017/07/18 | Accepted: 2017/10/18 | Published: 2017/10/18

1. Hinkle JL, Cheever KH. Brunner & Suddarth's textbook of medical-surgical nursing: Lippincott Williams & Wilkins; 2013.
2. Taylor C, Lillis C, Mone PL, Lynn P. Fundamentals of Nursing. 7th ed. philadelphia: Lippincott Williams and Wilkins; 2011.
3. Potter P, Perry A. Fundamentals of Nursing. 7th ed: Mosby Elsevier; 2009.
4. Proehl JA. Emergency Nursing Procedures. 4th ed. Tehran: Jameenegar; 2012. godarzi Z. General Principles injections. Tehran: Andisherafi; 2012.
5. Raichurkar A, Ramachandra KKB. Placebo Controlled Comparative Study of Efficacy of Diclofenac and Ketoprofen Transdermal Patches In Attenuating Intravenous Cannulation Pain. Journal of Dental and Medical Sciences. 2015;14(3):111-4.
6. Deshpande C, Jain V. Comparison between diclofenac transdermal patch vs transdermal emla (eutectic mixture of local anaesthetic) cream for attenuation of pain of venous cannulation. Journal of Anaesthesiology Clinical Pharmacology. 2010;26(2):231-6.
7. Ahn SN, Lee J, Kim HW, Im SB, Cho BS, Ahn HY. The effects of EMLA cream on pain responses of preschoolers. Open Journal of Nursing. 2013;3(8):1-4. [DOI:10.4236/ojn.2013.38A001]
8. Canbulat N, Ayhan F, Inal S. Effectiveness of external cold and vibration for procedural pain relief during peripheral intravenous cannulation in pediatric patients. Pain Manag Nurs. 2015;16(1):33-9. [DOI:10.1016/j.pmn.2014.03.003] [PMID]
9. Canbulat N, Inal S, Sönmezer H. Efficacy of distraction methods on procedural pain and anxiety by applying distraction cards and kaleidoscope in children. Asian Nurs Res (Korean Soc Nurs Sci). 2014;8(1):23-8. [DOI:10.1016/j.anr.2013.12.001] [PMID]
10. Moadad N, Kozman K, Shahine R, Ohanian S, Badr LK. Distraction using the BUZZY for children during an IV insertion. J Pediatr Nurs. 2016;31(1):64-72. [DOI:10.1016/j.pedn.2015.07.010] [PMID]
11. Alavi A, Zargham A. [The effect of bubble blowing on pain of venipuncture in children]. Scientific journal of kurdistan university of medical sciences. 2008 (3):77-82.
12. Kearl YL, Yanger S, Montero S, Morelos-Howard E, Claudius I. Does combined use of the J-tip® and Buzzy® device decrease the pain of venipuncture in a pediatric population? J Pediatr Nurs. 2015;30(6):829-33. [DOI:10.1016/j.pedn.2015.06.007] [PMID]
13. Taylor D. The Valsalva manoeuvre: a critical review. SPUMS Journal 1996;26(1):8-13.
14. Kirchner A, Stefan H, Bastian K, Birklein F. Vagus nerve stimulation suppresses pain but has limited effects on neurogenic inflammation in humans. Europ J Pain. 2006;10(5):449-55. [DOI:10.1016/j.ejpain.2005.06.005] [PMID]
15. Mohammadi SS, Pajand AG, Shoeibi G. Efficacy of the valsalva maneuver on needle projection pain and hemodynamic responses during spinal puncture. Int J Med Sci. 2011;8(2):156-60. [DOI:10.7150/ijms.8.156] [PMID] [PMCID]
16. Abogamal A. . Evaluationg the Effect of Valsalva Maneuver on Pain Occurring during Knee Injection: A Prospective, Randomized Study. Ann Rheum Dis. 2012;5(2).
17. Vijay V, Meenakshi A, Sukhpal K, Ashish B. Effect of Valsalva maneuver prior to peripheral intravenous cannulation on intensity of pain. Nursing and Midwifery Research Journal. 2013;9(4):143-51.
18. Asgari MR, Bakhtiary A, Ebrahimian A, Javadifar K. [The effect of different types of transcutaneous electrical nerve stimulations (TENS) on severity of pain related with insertion of intravenous catheter (Angiocut)]. Journal of Gorgan University of Medical Sciences. 2009;10(4):11-7.
19. Akdas O, Basaranoglu G, Ozdemir H, Comlekci M, Erkalp K, Saidoglu L. The effects of Valsalva maneuver on venipuncture pain in children: comparison to EMLA®(lidocaine–prilocaine cream). Ir J Med Sci (1971-). 2014;183(4):517-20. [DOI:10.1007/s11845-013-1037-4] [PMID]
20. Kirchner A, Stefan H, Schmelz M, Haslbeck K, Birklein F. Influence of vagus nerve stimulation on histamine-induced itching. Neurology. 2002;59(1):108-12. [DOI:10.1212/WNL.59.1.108] [PMID]
21. Basaranoglu G, Basaranoglu M, Erden V, Delatioglu H, Pekel A, Saitoglu L. The effects of Valsalva manoeuvres on venepuncture pain. Eur J Anaesthesiol. 2006;23(7):591-3. [DOI:10.1017/S0265021506000160] [PMID]
22. Kumar S, Gautam SKS, Gupta D, Agarwal A, Dhirraj S, Khuba S. The effect of Valsalva maneuver in attenuating skin puncture pain during spinal anesthesia: a randomized controlled trial. Korean J Anesthesiol. 2016;69(1):27-31. [DOI:10.4097/kjae.2016.69.1.27] [PMID] [PMCID]
23. Zhang R, Crandall CG, Levine BD. Cerebral hemodynamics during the Valsalva maneuver. Stroke. 2004;35(4):843-7. [DOI:10.1161/01.STR.0000120309.84666.AE] [PMID]
24. Suren M, Kaya Z, Ozkan F, Erkorkmaz U, Arıcı S, Karaman S. Comparison of the use of the Valsalva maneuver and the eutectic mixture of local anesthetics (EMLA®) to relieve venipuncture pain: a randomized controlled trial. J Anesth. 2013;27(3):407-11. [DOI:10.1007/s00540-012-1540-1] [PMID]

Add your comments about this article : Your username or Email:

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2015 All Rights Reserved | Iran Journal of Nursing

Designed & Developed by : Yektaweb