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



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.


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.


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).


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®.

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No external funding and no competing interests declared.

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Correspondence to G. Basaranoglu.

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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).

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