P B Sabitha, Khakha D C, Mahajan S, Gupta S, Agarwal M, Yadav S L
College of Nursing, All India Institute of Medical Sciences, New Delhi - 110 029, India.
Indian J Nephrol. 2008 Oct;18(4):155-8. doi: 10.4103/0971-4065.45290.
Pain during areteriovenous fistula (AVF) cannulation remains a common problem in hemodialysis (HD) patients. This study was undertaken to assess the effect of cryotherapy on pain due to arteriovenous fistula puncture in hemodialysis patients. A convenience sample of 60 patients (30 each in experimental and control groups) who were undergoing hemodialysis by using AVF, was assessed in a randomized control trial. Hemodialysis patients who met the inclusion criteria, were randomly assigned to experimental and control groups using a randomization table. Objective and subjective pain scoring was done on two consecutive days of HD treatment (with cryotherapy for the experimental and without cryotherapy for the control group). The tools used were a questionnaire examining demographic and clinical characteristics, an observation checklist for assessing objective pain behavior, and a numerical rating scale for subjective pain assessment. Descriptive statistics were used as deemed appropriate. Chi square, two-sample and paired t-tests, the Mann Whitney test, Wilcoxon's signed rank test, the Kruskal Wallis test, and Spearman's and Pearson's correlations were used for inferential statistics. We found that the objective and subjective pain scores were found to be significantly (P = 0.001) reduced within the experimental group with the application of cryotherapy. This study highlights the need for adopting alternative therapies such as cryotherapy for effective pain management in hospital settings.
动静脉内瘘（AVF）穿刺时的疼痛仍是血液透析（HD）患者的常见问题。本研究旨在评估冷冻疗法对血液透析患者动静脉内瘘穿刺所致疼痛的影响。在一项随机对照试验中，对60例使用动静脉内瘘进行血液透析的患者（试验组和对照组各30例）的便利样本进行了评估。符合纳入标准的血液透析患者使用随机数字表随机分为试验组和对照组。在连续两天的血液透析治疗中进行客观和主观疼痛评分（试验组采用冷冻疗法，对照组不采用冷冻疗法）。所使用的工具包括一份检查人口统计学和临床特征的问卷、一份评估客观疼痛行为的观察清单以及一份用于主观疼痛评估的数字评分量表。根据需要使用描述性统计。卡方检验、双样本和配对t检验、曼-惠特尼检验、威尔科克森符号秩检验、克鲁斯卡尔-沃利斯检验以及斯皮尔曼和皮尔逊相关性检验用于推断性统计。我们发现，试验组应用冷冻疗法后，客观和主观疼痛评分均显著降低（P = 0.001）。本研究强调了在医院环境中采用冷冻疗法等替代疗法进行有效疼痛管理的必要性。
