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.