#3369 THE EFFECT OF ACUPRESSURE APPLIED TO DIFFERENT FISTULA AREA ON FISTULE NEEDLE ENTRY PAIN
Authors: Turgay Gülay , Çevik Banu , İnanoğlu Işılay , Kaya Semiha 
Published: June 2023

Abstract

Background and Aims
This study was conducted to determine the effectiveness of acupressure application on Hegu point on the severity of acute pain caused by fistula needle in patients with brescia-cimino, snuff-box and antecubital fistula.

Method
This study was randomized control study which was conducted with 66 intervention and 65 control participants, recruited from a dialysis centre of a foundation university in Turkey between October 2021 and February 2022. Simple randomization was used for sample selection in the study. The participants in the intervention group were divided into 3 groups according to the fistula area. The first group was consisted of participants with brescia-cimino fistula, the second group was consisted of participants with snuff-box fistula, and the third group was consisted of participants with antecubital fistula. The of all 22 participants were assigned to each group in the intervention group. Acupressure was applied 3 minute before needle placement in the fistula area of the participants in the intervention group. No intervention was made in the control group in the study. Data were collected usıng Descriptive Information Form and pain scale (Numeric Analog Scale-NRS). NRS was used to determine the severity of acute pain experienced by patients during fistula needle insertion. Since the data of the study showed normal distribution, the data were analyzed with parametric tests. The independent sample t-test was used to examine the homogeneity of the data between the two groups. Spearman correlation analyses were used to compare categorical variables. Statistical significance was assumed at p &lt;0,05.

Results
In the study, the groups are similar to each other (p&gt;0.05). In the study, the mean age of the participants in the intervention group was 60.50±15.19, and 40.9% of them were in the 61-75 age group. The mean duration of hemodialysis was 7.31±3.31 (min:1-max:20). Of the participants, 43.9% had antecubital, 33.3% had a brescia-cimino fistula and 27.7% had a snuff-box fistula. The mean age of the participants in the control group was 60.84±15.34 years, and 33.8% of them were in the 61-75 age group. The mean duration of hemodialysis was 7.27±4.29 (min:1-max:20). 35.4% of the participants had antecubital, 30.8% had brescia-cimino fistula and 33.8% had snuff-box fistula. While there was no decrease in the severity of acute pain during fistula needle insertion in the participants in the control group, a significant decrease was found in the mean acute pain severity scores experienced by the patients in the intervention group, where acupressure was applied to the Hegu (LI4) acupuncture point (p&lt;0.05, Table 1). In the study, there was a difference within the groups in terms of the mean acute pain severity scores of different fistula areas in the intervention group but, there was no difference in acute pain severity scores between the groups in three different fistula areas.

Conclusion
The results of this study support that acupressure applied to the Hegu acupuncture point was effectiveness in reducing acute pain at fistula needle insertion in different dialysis fistula area. In addition, the results of the study provide a practical and cost-effective reference for dialysis nurses in acute pain management.