Breathing Exercises, Valsalva Maneuver Reduce Pain in Peripheral Intravenous Catheterization: Randomized Trial

Abstract

Objective: This study aimed to determine the effects of breathing exercises and the Valsalva maneuver on invasive pain associated with peripheral intravenous catheterization (PIVC).

Method: This randomized controlled trial was conducted between March and June 2025 with three groups: Valsalva group (n = 46), breathing exercise group (n = 46), and control group (n = 46). Data were collected using the "Nurse Descriptive Information Form" and the "Visual Analog Scale (VAS)."

Results: Pain levels during and after peripheral intravenous catheterization were significantly lower in the Valsalva maneuver and breathing exercise groups compared to the control group (p < .001, p < .001; η² = 0.195, η² = 0.169, respectively). However, there was no statistically significant difference between the Valsalva manoeuvre and breathing exercise groups in terms of pain reduction (p > .05).

Conclusion: The findings indicate that the Valsalva manoeuvre and breathing exercises are effective non-pharmacological techniques for reducing pain during peripheral intravenous catheterization.

Relevance to clinical practice: Simple, non-pharmacological interventions such as the Valsalva maneuver and breathing exercises can effectively reduce pain during peripheral intravenous catheterization. Integrating these easy-to-apply methods into nursing practice may enhance patient comfort and support patient-centered care.

Reporting method: This study adhered to the CONSORT guidelines for non-pharmacological randomized clinical trials.

Trial registration: This study was registered at ClinicalTrials.gov with registration number NCT06872671.

Keywords: Breathing exercises; Nursing; Pain; Valsalva manoeuvre.