Response of arteriovenous fistula puncture-related pain to different cryotherapy applications in hemodialysis patients: a randomized controlled study

Introduction. Patients receiving continuous hemodialysis commonly experience pain associated with arteriovenous fistula puncture. Relieving the pain may increase their appreciation of the procedure and hence their quality of life. Aim. To find out how different ways of applying cryotherapy changed the pain of arteriovenous fistula punctures in hemodialysis patients. Materials and methods. During the seven weeks of this randomized controlled study, ninety hemodialysis patients of both sexes with end-stage renal disease who had received medical treatment were allocated to one of three groups at random: ipsilateral (received cryotherapy at the site of needle insertion), contralateral (received cryotherapy at the site opposite to the needle insertion), or control (followed medical treatment without cryotherapy application). Cryotherapy was applied for five to ten minutes, three times a week. Prior to and following the seven-week intervention period, assessments of upper limb function (by Arm Motor Ability Test), pain severity (by Visual Analogue Scale), beside anxiety and depression (by Hospital Anxiety and Depression Scale) were carried out. Results and discussion. The final results showed that all evaluated outcomes improved after the intervention, with no statistically significant difference between the ipsilateral and contralateral groups (p ≥ 0.05). Yet, when comparing the contralateral or ipsilateral groups to the control group, all parameters had statistically significant differences (p 0.05). Conclusion. For hemodialysis patients, cryotherapy is one of the best ways to manage pain from arteriovenous fistula punctures, upper limb dysfunction, depression, and anxiety.