Comparison of the effects of cryotherapy and placebo on reducing the pain of arteriovenous fistula cannulation among hemodialysis patients: A randomized control trial

Background and Purpose: Pain perception with arteriovenous fistula (AVF) cannulation is a major concern among patients undergoing hemodialysis. This study aimed to compare the efficacy of cryotherapy and placebo in the reduction of AVF puncture-related pain in hemodialysis patients. Methods: This randomized clinical trial was conducted on 50 patients undergoing hemodialysis selected via random sampling. Patients were randomly divided into two groups of intervention and control. Patients in the intervention group received cryotherapy using ice cubes wrapped in latex gloves, which were placed on the back of the hands without AVF (between the index finger and thumb). The same process was performed on the patients of the control group by using wooden cubes as placebo instead of ice cubes. Pain perception of the patients was recorded during two consecutive hemodialysis sessions using a visual analogue scale. Data analysis was performed in SPSS V.13 using Chi-square and independent T-test. Results: With cryotherapy, scores of AVF puncture-related pain significantly reduced from 5.9±0.96 in session one (routine care) to 3.2±1.71 in session two of hemodialysis. However, no significant difference was observed between the two sessions in patients of the control group (P=0.07). Conclusion: According to the results of this study, cryotherapy, as a non-pharmacological and complementary approach, could be effective in the prevention of the pain associated with AVF cannulation. Therefore, it is recommended that nurses apply this method before AVF cannulation in order to alleviate pain intensity in hemodialysis patients.