Evaluating the Effect of the Valsalva Maneuver on Invasive Pain During Arteriovenous Fistula Cannulation in Hemodialysis Patients

Launched by CANSU POLAT DÜNYA · Jul 5, 2025

Keywords

ClinConnect Summary

This clinical trial is studying whether a simple breathing technique called the Valsalva maneuver can help reduce pain during needle insertion into the arteriovenous fistula (AVF) — the special blood vessel used for dialysis treatment in adults. The researchers want to find out if doing this maneuver makes the needle insertion less painful and if patients find it easy and comfortable enough to use every time they have dialysis. They will compare patients who use the Valsalva maneuver during their treatment to those who receive the usual care without this technique.

Adults who have been on hemodialysis through an AVF for at least three months, are able to do the Valsalva maneuver safely, and have reported some pain during needle insertion may be eligible to join. Participants will be trained on how to do the maneuver and will use it during each dialysis session for a total of 12 times. After each session, they will rate their pain, and at the end, they will share how satisfied they were with using the technique. This study aims to see if this simple breathing method can make dialysis treatments more comfortable without adding any risks or complications.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Age 18 years or older
• • Receiving hemodialysis treatment via arteriovenous fistula for at least 3 months
• • No analgesic medication use within the past 24 hours
• • Systolic blood pressure between 90-160 mmHg and diastolic between 60-100 mmHg
• • Pain score ≥ 1 on Visual Analogue Scale during AVF cannulation
• • Able to perform the Valsalva maneuver (no contraindications)
• • No communication barriers or severe psychiatric disorders
• • Provided written informed consent
• Exclusion Criteria:
• • Unable to correctly perform the Valsalva maneuver
• • Failed first cannulation attempt
• • History of acute myocardial infarction or malignant arrhythmia
• • Aneurysm, infection, edema, or scar tissue at AVF site
• • Pregnancy
• • Voluntary withdrawal from the study at any stage
• • Switching dialysis centers or requiring hospitalization during the study