Comparing the Effect of Cryotherapy and Acupressure on Pain Intensity of Arteriovenous Fistula Cannulation in Patients Hemodialysis

Introduction: Patients with kidney failure undergoing hemodialysis are frequently exposed to the hemodialysis needles are inserted into the arteriovenous fistulas; one of the important interventions in nursing care is use of nonpharmacological interventions for relief pain. Therefore, this study was conducted to compare the effect of cryotherapy and acupressure on the pain intensity of needle insertion into arterial-venous fistula in hemodialysis patients. Methods: This research is a single-group, quasi-experimental study by census sampling which was performed on 42 hemodialysis women patients at selected hospitals in Kerman city in 2017.Data collection conducted by demographic questionnaire and pain numerical pain scale. A measurement of pain was done during three consecutive hemodialysis sessions, the first day no intervention, cryotherapy and acupressure intervention was done on the second and third day. In every stage, after being fixed the needle into the arteriovenous fistula vessels, pain was measured using numerical scale. Each cryotherapy and acupressure intervention was performed for 10 minutes on the Hugo point of hand not having A-V fistula (contralateral arm). Results: Most of patients experienced moderate pain without intervention (52.38%), mild pain with cryotherapy intervention (52.38%), and moderate pain after acupressure intervention (54.77%). The mean score of pain was decreased in both acupressure methods (4.19 ± 2.43) and cryotherapy (3.16 ± 2.17) compared to the no intervention technique (6.52 ± 1.82). This difference was significant so that the cryotherapy with mean ordinal score of (1.38) was more effective in reducing pain (P = 0.001). Conclusions: Applying cryotherapy on Hugo point of contralateral hand A-V fistula more than the acupressure has reduced pain of needle insertion. It is recommended to take into account comfort and relaxation of the patient, nurses using cryotherapy method to reduce pain for hemodialysis patients.