{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T15:29:53Z","timestamp":1788881393754,"version":"build-2803163510"},"reference-count":26,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T00:00:00Z","timestamp":1687132800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Study Program of Nurse Association of Guangdong Province","award":["gdshsxh2021b009"],"award-info":[{"award-number":["gdshsxh2021b009"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Totally implantable access port (TIAP) is a subcutaneously implanted, long-term infusion device that is widely used in oncology patients. However, multiple needle insertions into TIAP may lead to pain, anxiety, and dread in patients. This study aimed to compare the effectiveness of Valsalva maneuver, eutectic mixture of local anesthetics (EMLA) cream, and the combination of both in relieving pain of cannulations on TIAP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This was a prospective randomized controlled study. We included 223 patients treated with antineoplastic drugs and randomized them into four groups: EMLA Group (Group E), control Group (Group C), Valsalva maneuver Group (Group V), and EMLA cream combing with Valsalva maneuver Group (Group EV). Each group was given the corresponding intervention before non-coring needle insertion. The data on pain scores and overall comfort were collected by numerical pain rating scale (NPRS) and visual analog scale (VAS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Group E and Group EV experienced the least amount of pain scores in needle insertion, which was significantly lower than Group V and Group C ( p\u2009&lt;\u20090.05). Meanwhile, Group E and Group EV obtained the highest comfort level, which was significantly higher than group C ( p\u2009&lt;\u20090.05). Fifteen patients developed localized skin erythema after the application of medical Vaseline or EMLA cream and subsided within half an hour after rubbing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>EMLA cream is a safe and effective way to alleviate pain during non-coring needle insertion in TIAP and enhance the overall comfort of patients. We recommend applying EMLA cream 1\u2009h before needle insertion of TIAP, especially in patients having needle phobia or high pain scores from previous non-coring needle insertion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11297298231169155","type":"journal-article","created":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T05:42:55Z","timestamp":1687153375000},"page":"1576-1583","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Comparison of the effects of Valsalva maneuver, EMLA cream, and the combination of both in relieving pain of needle insertion on totally implantable access port: A randomized controlled study"],"prefix":"10.1177","volume":"25","author":[{"given":"Simei","family":"Shi","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4799-1932","authenticated-orcid":false,"given":"Ruiyun","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuxia","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanshan","family":"Qu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingtao","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiulian","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youjing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6712-1611","authenticated-orcid":false,"given":"Mingzhu","family":"Xin","sequence":"additional","affiliation":[{"name":"Department of Nursing, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,6,19]]},"reference":[{"issue":"12","key":"bibr1-11297298231169155","first-page":"1029","volume":"24","author":"Shanghai Cooperation Group on Central Venous Access","year":"2015","journal-title":"J Intervent Radiol"},{"issue":"5","key":"bibr2-11297298231169155","volume":"92","author":"Capozzi VA","year":"2021","journal-title":"Acta bio-medica: Atenei Parmensis"},{"issue":"04","key":"bibr3-11297298231169155","first-page":"132","volume":"15","author":"Wen Y","year":"2018","journal-title":"Nurs Prac Res"},{"issue":"12","key":"bibr4-11297298231169155","first-page":"1123","volume":"28","author":"Shanghai Cooperation Group on Central Venous Access, Expert Committee on Vascular Access, Committee of Experts on Focused Diagnosis and Treatment of Solid Tumors, Shanghai Anti-Cancer Association","year":"2019","journal-title":"J Intervent Radiol"},{"key":"bibr5-11297298231169155","doi-asserted-by":"publisher","DOI":"10.1177\/1129729820959928"},{"issue":"19","key":"bibr6-11297298231169155","first-page":"1793","volume":"31","author":"Huang B","year":"2016","journal-title":"J Nurse Train"},{"key":"bibr7-11297298231169155","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol28020141"},{"issue":"4","key":"bibr8-11297298231169155","first-page":"213","volume":"23","author":"Moureau N","year":"2000","journal-title":"J Intraven Nurs"},{"issue":"13","key":"bibr9-11297298231169155","first-page":"2335","volume":"40","author":"Dun J","year":"2021","journal-title":"Int J Nurs"},{"key":"bibr10-11297298231169155","doi-asserted-by":"publisher","DOI":"10.1177\/1043454206296023"},{"issue":"10","key":"bibr11-11297298231169155","first-page":"1419","volume":"42","author":"Li L","year":"2017","journal-title":"J Bengbu Med Coll"},{"key":"bibr12-11297298231169155","doi-asserted-by":"publisher","DOI":"10.1177\/1129729818768182"},{"key":"bibr13-11297298231169155","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-012-1540-1"},{"issue":"5","key":"bibr14-11297298231169155","first-page":"108","volume":"27","author":"Hobek AR","year":"2021","journal-title":"Altern Ther Health Med"},{"issue":"12","key":"bibr15-11297298231169155","first-page":"920","volume":"44","author":"Zheng X","year":"2014","journal-title":"J Wenzhou Med Univer"},{"issue":"24","key":"bibr16-11297298231169155","first-page":"2282","volume":"34","author":"Zhang Y","year":"2019","journal-title":"J Nurses Train"},{"key":"bibr17-11297298231169155","doi-asserted-by":"publisher","DOI":"10.1017\/S0265021506000160"},{"key":"bibr18-11297298231169155","doi-asserted-by":"publisher","DOI":"10.3758\/BF03193146"},{"issue":"3","key":"bibr19-11297298231169155","first-page":"181","volume":"8","author":"Wang A","year":"2015","journal-title":"J Prac Dermat"},{"key":"bibr20-11297298231169155","doi-asserted-by":"publisher","DOI":"10.1007\/s002689900342"},{"issue":"9","key":"bibr21-11297298231169155","first-page":"1407","volume":"32","author":"Kong D","year":"2018","journal-title":"Chin Nurs Res"},{"issue":"11","key":"bibr22-11297298231169155","first-page":"117","volume":"23","author":"Wu X","year":"2011","journal-title":"Strait Pharm J"},{"key":"bibr23-11297298231169155","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0253048"},{"key":"bibr24-11297298231169155","doi-asserted-by":"publisher","DOI":"10.1016\/j.cden.2010.06.012"},{"key":"bibr25-11297298231169155","unstructured":"Drug.com. 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(2022-7-1)[2022-10-08]. https:\/\/www.drugs.com\/pro\/emla.html."},{"key":"bibr26-11297298231169155","doi-asserted-by":"publisher","DOI":"10.4103\/ajts.AJTS_95_20"}],"container-title":["The Journal of Vascular Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298231169155","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11297298231169155","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298231169155","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T03:22:42Z","timestamp":1777692162000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11297298231169155"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,19]]},"references-count":26,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1177\/11297298231169155"],"URL":"https:\/\/doi.org\/10.1177\/11297298231169155","relation":{},"ISSN":["1129-7298","1724-6032"],"issn-type":[{"value":"1129-7298","type":"print"},{"value":"1724-6032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,19]]}}}