Skip to main content
SpringerLink
Log in

The effects of Valsalva maneuver on venipuncture pain in children: comparison to EMLA® (lidocaine–prilocaine cream)

Irish Journal of Medical Science (1971 -) volume 183, pages 517–520 (2014)Cite this article

Abstract

Background

Venipuncture is one of the most painful events for children in hospitals. Valsalva maneuver (VM) decreases the incidence and severity of pain on venipuncture pain in adults. This study was designed to evaluate VM as compared with Eutectic Mixture of Local Anesthetic (EMLA®) cream for venipuncture pain in children.

Method

In this study, we evaluated the effect of VM on venipuncture pain in children. 60 patients scheduled for elective surgery were randomly divided into three groups. In Group V, children were punctured during VM. In Group E, EMLA® 5 % cream and in Group C (control group) vaseline was applied on the non-dominant hand 60 min before the venipuncture. Patients made a pain assessment using visual analog score (VAS). Mean arterial pressure (MAP), heart rate (HR), and SpO2 measurements were obtained during the venous cannulation.

Results

Respectively, the VAS was 2.15 ± 1.95 for Group V and 1.00 ± 0.79 for Group E and 2.55 ± 2.74 for Group C. A significant reduction in the severity of pain was observed in Group E. The difference being statistically significant (p < 0.05), the VAS of Group V was higher than Group E but lower than Group C (p > 0.05).

Conclusions

On the basis of data from this study, the VM is a simple and a practical method to reduce venipuncture pain in children but not as effectively as EMLA®.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

References

  1. Macario A, Weinger M, Truong P et al (1999) Which clinical anesthesia outcomes are both common and important to avoid? The perspective of a panel of expert anesthesiologists. Anesth Analg 88:1085–1091

    PubMed  CAS  Google Scholar 

  2. Wong DL, Baker CM (1988) Pain in children: comparison of assessment scale. Pediatr Nurse 14:9–17

    CAS  Google Scholar 

  3. Humphrey GB, Boon CM, van Linden van den Heuvell GF et al (1992) The occurrence of high levels of acute behavioral distress in children and adolescents undergoing routine venipunctures. Pediatrics 90:87–91

    PubMed  CAS  Google Scholar 

  4. Gupta D, Agarwal A, Dhiraaj S et al (2006) An evaluation of efficacy of balloon inflation on venous cannulation pain in children: a prospective, randomized, controlled study. Anesth Analg 102:1372–1375

    Article  PubMed  Google Scholar 

  5. Rogers TL, Ostrow CL (2004) The use of EMLA cream to decrease venipuncture pain in children. J Pediatr Nurs 19:33–39

    Article  PubMed  Google Scholar 

  6. Manimala R, Blount R, Cohen L (2000) The effects of parental reassurance versus distraction on child distress and coping during immunizations. Child Health Care 29:161–177

    Article  Google Scholar 

  7. Doellman D (2003) Pharmacological versus nonpharmacological techniques in reducing venipuncture psychological trauma in pediatric patients. J Infus Nurs 26:103–109

    Article  PubMed  Google Scholar 

  8. Tufekci FG, Celebioglu A, Kucukoglu S (2009) Turkish children loved distraction: using kaleidoscope to reduce perceived pain during venipuncture. J Clin Nurs 18:2180–2186

    Article  PubMed  Google Scholar 

  9. Furuya A, Ito M, Fukao T et al (2009) The effective time and concentration of nitrous oxide to reduce venipuncture pain in children. J Clin Anesth 21:190–193

    Article  PubMed  CAS  Google Scholar 

  10. Usichenko TI, Pavlovic D, Foellner S et al (2004) Reducing venipuncture pain by a cough trick: a randomized crossover volunteer study. Anesth Analg 98:343–345

    Article  PubMed  Google Scholar 

  11. Liossi C, White P, Hatira P (2009) A randomized clinical trial of a brief hypnosis intervention to control venipuncture-related pain of paediatric cancer patients. Pain 142:255–263

    Article  PubMed  Google Scholar 

  12. Kirchner A, Stefan H, Bastian K et al (2006) Vagus nerve stimulation suppresses pain but has limited effects on neurogenic inflammation in humans. Eur J Pain 10:449–455

    Article  PubMed  Google Scholar 

  13. Langham BT, Harrison DA (1993) The pressor response to venous cannulation: attenuation by prior infiltration with local anaesthetic. Br J Anaesth 70:519–521

    Article  PubMed  CAS  Google Scholar 

  14. Pavlin DJ, Links S, Rapp SE et al (1993) Vaso-vagal reactions in an ambulatory surgery center. Anesth Analg 76:931–935

    Article  PubMed  CAS  Google Scholar 

  15. Basaranoglu G, Basaranoglu M, Erden V et al (2006) The effects of Valsalva manoeuvres on venepuncture pain. Eur J Anaesthesiol 23:591–593

    Article  PubMed  CAS  Google Scholar 

  16. Agarwal A, Sinha PK, Tandon M et al (2005) Evaluating the efficacy of the Valsalva maneuver on venous cannulation pain: a prospective, randomized study. Anesth Analg 101:1230–1232

    Article  PubMed  Google Scholar 

  17. Kirchner A, Birklein F, Stefan H et al (2000) Left vagus nerve stimulation suppresses experimentally induced pain. Neurology 55:1167–1171

    Article  PubMed  CAS  Google Scholar 

  18. Kirchner A, Stefan H, Schmelz M et al (2002) Influence of vagus nerve stimulation on histamine-induced itching. Neurology 59:108–112

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

No external funding and no competing interests declared.

Author information

Authors and Affiliations

  1. Anesthesia and Reanimation Clinics, Banaz State Hospital, Usak, Turkey

    O. Akdas

  2. Anesthesia and Reanimation Clinics, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey

    G. Basaranoglu

  3. Anesthesia and Reanimation Clinics, Bezmialem Valide Sultan Vakif Gureba Hospital, Istanbul, Turkey

    H. Ozdemir

  4. Department of Anaesthesiology and Reanimation, Bagcılar Training and Research Hospital, Istanbul, Turkey

    M. Comlekci & K. Erkalp

  5. Department of Anaesthesiology and Reanimation, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey

    L. Saidoglu

Authors
  1. O. Akdas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Basaranoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. Ozdemir
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Comlekci
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. K. Erkalp
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. L. Saidoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to G. Basaranoglu.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Akdas, O., Basaranoglu, G., Ozdemir, H. et al. The effects of Valsalva maneuver on venipuncture pain in children: comparison to EMLA® (lidocaine–prilocaine cream). Ir J Med Sci 183, 517–520 (2014). https://doi.org/10.1007/s11845-013-1037-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-013-1037-4

Keywords

search

Navigation