MO780: Effect of Acupressure Applied to Li4 Point on Fistula Needle Pain Intensity in Haemodialysis Patients

Abstract BACKGROUND AND AIMS Arteriovenous fistula (AVF) is the most reliable method for vascular access, which is vital for haemodialysis patients. To perform haemodialysis therapy, AVF cannulation is by puncture with thick needles three to four times a week. Patients usually feel pain while a needle is inserted into the fistula [1]. This acute pain can be relieved by acupressure, which is a non-pharmacological application method. It is stated in the literature that acupressure is especially effective in acute pain management. This study was designed to evaluate the effect of acupressure application to the LI4 point on the severity of acute pain caused by fistula needle insertion in patients with antecubital arteriovenous fistula [2–3]. METHOD This study was conducted as a randomized controlled experimental study in a total of 64 patients who received haemodialysis treatment between 15 November 2021 and 5 January 2022 in the Dialysis Centre of a foundation university in Turkey. Inclusion criteria for the study; have an antecubital fistula; ≥18 years; can speak Turkish, not using analgesics in the last 6 h; no extremity pain; no bleeding or coagulation problems and volunteering to participate in the study. In the study, data were collected using the patient identification form and the Visual Analogue Scale (VAS) for measuring the pain intensity of the individual. In the experimental group, in the first dialysis session of the week, a needle was inserted into the patient's arteriovenous fistula by the nurse, and the pain intensity was measured with VAS. In the second and third sessions of the same week, finger acupressure was applied for 3 min before the fistula needle insertion and the patient's pain intensity was evaluated with VAS after needle insertion. Fistula needle insertion was performed by the same nurse in all patients. Descriptive statistics, including mean, standard deviation, frequency distribution; Wilcoxon, Mann–Whitney U and Friedman test were used. P < 0.05 was considered as significant level. RESULTS In this study, data were found to be similar in terms of age, gender, education level, duration of dialysis treatment and VAS mean score. While there was no decrease in the severity of acute pain during fistula needle insertion of the patients in the control group, there was a significant decrease in the mean acute pain severity scores experienced by the patients in the experimental group, whose LI4 point acupressure was applied during fistula needle insertion (P < 0.05) (Table). CONCLUSION The results of this study support the effectiveness of LI 4 acupressure point can be conducted as an effective and low-cost way to reduce the acute pain of needle insertion in fistulas in dialysis patients. In addition, the results provide a practical reference to acute pain management for dialysis nurses.