The Effect of Valsalva Maneuver on Pain Intensity and Hemodynamic Changes during Intravenous (IV) Cannulation

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.
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).
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.
The Valsalva maneuver is a non-pharmacological method that can be easily performed and reduces cannulation pain without making hemodynamic changes.