{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T23:52:12Z","timestamp":1788479532483,"version":"build-2803163510"},"reference-count":51,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T00:00:00Z","timestamp":1672099200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:p>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 \u201cValsalva Maneuver,\u201d \u201cValsalva\u2019s Maneuver,\u201d \u201cForced Expiratory,\u201d \u201cBalloon Inflation,\u201d \u201cPain,\u201d \u201cAche,\u201d \u201cCannulation,\u201d \u201cPeripheral Intravenous Cannulation,\u201d \u201cPeripheral Catheterization,\u201d \u201cVascular Access,\u201d \u201cVenous Cannulation,\u201d \u201cVenous Catheterization,\u201d and \u201cCatheterization,\u201d 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: \u22121.20, 95% Confidence Interval: \u22121.69 to \u22120.71, p\u2009&lt;\u20090.001). 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: \u22121.26, 95% Confidence Interval: \u22121.90 to \u22120.62, p\u2009&lt;\u20090.001 (and Visual Analog Scale (Effect Size: \u22121.09, 95% Confidence Interval: \u22121.98 to \u22120.20, p\u2009=\u20090.016). Valsalva maneuver significantly increased the mean heart rate (Weighted Mean Difference: 1.90, 95% Confidence Interval: 1.56\u20132.24, p\u2009&lt;\u20090.001), decreased the mean arterial pressure (Weighted Mean Difference: 0.73, 95% Confidence Interval: \u22120.13 to 1.60, p\u2009=\u20090.096), and caused a non-significant decrease in anxiety (Weighted Mean Difference: \u22121.95, 95% Confidence Interval: \u22125.24 to 1.34, p\u2009=\u20090.25). 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.<\/jats:p>","DOI":"10.1177\/11297298221145982","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T08:14:23Z","timestamp":1672128863000},"page":"1051-1062","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["The effects of Valsalva maneuver on pain intensity and hemodynamic status during short peripheral cannula insertion in adults: A systematic review and meta-analysis"],"prefix":"10.1177","volume":"25","author":[{"given":"Seyed Javad","family":"Hosseini","sequence":"first","affiliation":[{"name":"Department of Pediatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, 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