本系统评价和荟萃分析旨在总结有关Valsalva动作对成人短外周插管插入疼痛严重程度和血流动力学状态影响的随机临床试验研究。在PubMed上进行了系统搜索,WebofScience,Scopus数据库,科克伦,ClinicalTrials.gov,和谷歌学者搜索引擎使用从医学主题词中提取的关键词,比如“瓦尔萨尔瓦机动”,\"\"Valsalva\的机动,\"\"强迫呼气,\“\”气球通货膨胀,\"\"疼痛,\"\"Ache,\"\"套管,\"\"外周静脉插管,\"\"周围导管术,\"\"血管通路,\"\"静脉插管,\"\"静脉置管,\"和\"插管,“从成立到2022年1月1日。最后,本系统综述和荟萃分析的定性和定量分析包括12和11篇文章,分别。总的来说,基于数字评定量表和视觉模拟量表的疼痛强度导致了大的临床效果(效果大小:-1.20,95%置信区间:-1.69至-0.71,p<0.001)。在两个量表的单独研究中观察到了较大的临床效果,因为在基于数字评定量表的研究中已经确定了临床效果(效果大小:-1.26,95%置信区间:-1.90至-0.62,p<0.001(和视觉模拟量表(效果大小:-1.09,95%置信区间:-1.98至-0.20,p=0.016)。Valsalva动作显着增加了平均心率(加权平均差:1.90,95%置信区间:1.56-2.24,p<0.001),降低平均动脉压(加权平均差:0.73,95%置信区间:-0.13至1.60,p=0.096),并导致焦虑无显著降低(加权平均差:-1.95,95%置信区间:-5.24至1.34,p=0.25)。结果表明,Valsalva动作可显着降低疼痛强度。因此,建议护士将其用作一种方便且低成本的非药物干预措施,以减轻非心脏病患者疼痛的严重程度.此外,建议采用强有力的方法学设计进行研究,并在今后的研究中考虑其对血流动力学参数的影响.
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 \"Valsalva Maneuver,\" \"Valsalva\'s Maneuver,\" \"Forced Expiratory,\" \"Balloon Inflation,\" \"Pain,\" \"Ache,\" \"Cannulation,\" \"Peripheral Intravenous Cannulation,\" \"Peripheral Catheterization,\" \"Vascular Access,\" \"Venous Cannulation,\" \"Venous Catheterization,\" and \"Catheterization,\" 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: -1.20, 95% Confidence Interval: -1.69 to -0.71, p < 0.001). 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: -1.26, 95% Confidence Interval: -1.90 to -0.62, p < 0.001 (and Visual Analog Scale (Effect Size: -1.09, 95% Confidence Interval: -1.98 to -0.20, p = 0.016). Valsalva maneuver significantly increased the mean heart rate (Weighted Mean Difference: 1.90, 95% Confidence Interval: 1.56-2.24, p < 0.001), decreased the mean arterial pressure (Weighted Mean Difference: 0.73, 95% Confidence Interval: -0.13 to 1.60, p = 0.096), and caused a non-significant decrease in anxiety (Weighted Mean Difference: -1.95, 95% Confidence Interval: -5.24 to 1.34, p = 0.25). 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.