Pain during Arterio-Venous Fistula (AVF) Cannulation

Abstract

Pain caused by medical care is a major concern of patients. Patients undergoing hemodialysis are submitted to two venous punctures at rate of two or three times per week and this by means of big needles gauge. Where pain during Arterio-Venous Fistula (AVF) cannulation should be the object of adequate take care. However few works are dedicated to it. Our purpose was to estimate prevalence, risk factors and take care of pain due to AVF cannulation to hemodialysis patients. It was monocenter study realized from 1st till 30 September 2013 in the unit of hemodialysis of University Teaching Hospital Ibn Rochd of Casablanca. It included 92 hemodialysis patients, who's carried AVF dating of at least three months and having agreed to participate that study. The investigation was realized by a doctor. The content of the tools used for investigation was established and validated by our department. Intensity of pain estimated by means of an analogue visual scale, was quoted from 0 to 10. The pain was estimated at every patient's during two consecutive hemodialysis sessions just after the bipunction of AVF by means of needles of 16 gauge by the same nurse. The mean age was 43,76 ± 13,6 years with a parity of sex. Prevalence of pain was 60,9 % with a moderate intensity expressed in 63 % of cases. About 31,5 % had apprehension of puncture. The anesthetic cream was the only method used for pain take care and its rate of use was 3,6 %. The risk factors of the pain were: proximal situation of AVF (p=0,020), apprehension of puncture (p=0,037). In our hemodialysis center, pain during AVF cannulation remains a real problem both by its high prevalence and its lower take care. Where it imports to elaborate a strategy to manage this pain.

Comparison of the Effects of Visual and Auditory Distractions on Fistula Cannulation Pain among Older Patients Undergoing Hemodialysis: A Randomized Controlled Clinical Trial

“…These patients receive AVF cannulation three times per week and often express pain, which is their greatest concern during the insertion of a needle into AVF [2,3]. It has been reported that about 80% of patients undergoing hemodialysis experience moderate to very severe pain during AVF cannulation, but they do not receive pain relief [4]. Struggling with pain during hemodialysis can lead to frustration, despair, and lack of adherence to the therapeutic regimen [5].…”

Valsalva Maneuver to Decrease Pain Intensity During Arteriovenous Fistula Insertion in Hemodialysis Patients

“…Arteriovenous (AV) fistula is a type of surgery usually performed on the forearm that combines arteries and large veins to produce a fistula (Rosdahl & Kowalski, 2012). Patients receiv-ing hemodialysis often feel the effects of using AV fistulas, which includes pain during needle insertion (Kaza et al, 2014). Pain during AV fistula insertion is a real problem among hemodialysis patients.…”

“…Pain during AV fistula insertion is the most common complaint among patients receiving hemodialysis (Figueiredo, Viegas, Monteiro, & Poly-De-Figueiredo, 2008). Patients undergoing AV fistula insertion for hemodialysis twice a week experience pain each time the procedure is carried out (Kaza et al, 2014).…”

Management Strategies for Pain Associated with Arteriovenous Fistula Cannulation: An Integrative Literature Review

“…6 Indeed, pain related to exposure to at least three punctures per week was reported as a major challenge by 57% of patients treated with hemodialysis. 7 Second, it may increase nonadherence to recommended dialysis regimen, 8 and thus increase mortality rate due to increase in cardiovascular and respiratory complications. 7 Second, it may increase nonadherence to recommended dialysis regimen, 8 and thus increase mortality rate due to increase in cardiovascular and respiratory complications.…”

“…5 Uncontrolled cannulation pain remains a major issue for two reasons: First, it imposes an additional burden to the quality of life. 7 Second, it may increase nonadherence to recommended dialysis regimen, 8 and thus increase mortality rate due to increase in cardiovascular and respiratory complications. 9 Nurses have been recognized as primary health-care providers for patients on hemodialysis.…”