Efficacy of Interventions to Reduce Arteriovenous Fistula Cannulation-Related Pain in Patients Undergoing Haemodialysis: A Systematic Review and Meta-Analysis.

BACKGROUND

Experiencing continued pain affects the level of haemodialysis adherence in patients and ultimately decrease quality of life. Therefore, pain control is an important priority in these patients. No systematic review and meta-analyses study about the effect of intervention (invasive and noninvasive intervention) on the arteriovenous fistula cannulation-related pain has yet been carried out.

OBJECTIVES

This systematic review with meta-analysis was conducted to assess the evidence for the effectiveness of intervention to reduce the arteriovenous fistula cannulation-related pain in patients undergoing haemodialysis.

METHODS

Using English databases, including PubMed, Web of Science, Scopus, Science Direct, ProQuest, ProQuest Dissertations & Theses Global, and EBSCOHOST were systematically searched from their inception to April 2025. Two reviewers independently assessed the risk of bias using the JBI RCT checklist. The Comprehensive Meta-Analysis® software version 3.0 (Biostat) was used for data analysis.

RESULTS

Twenty-two randomised controlled trials examined the effects of interventions to alleviate the arteriovenous fistula cannulation-related pain including invasive and noninvasive interventions related studies. Invasive interventions buttonhole cannulation, using plastic needle and using indwelling needles. Noninvasive methods include cryotherapy or using a local skin cooling device, aromatherapy, foot reflexology, US-guided cannulation, antistress balls, listening to music or running water, virtual reality distraction, breathing exercise, and acupressure on patients with haemodialysis.

CONCLUSION

The study demonstrated that invasive and noninvasive interventions had beneficial effects on the fistula cannulation-related pain. However, due to the heterogeneity and the lack of follow-up studies, more high-quality studies are needed to confirm the results of our review and to clarify the long-term effects of interventions.