The Effect of Lidocaine Gel on Needle Puncture Pain in Hemodialysis Patients: A Randomized Controlled Trial/Hemodiyaliz Hastalarında İğne Girişi Ağrısı Üzerine Lidokain Jelinin Etkisi: Randomize Kontrollü Bir Çalışma

Year 2026, Volume: 21 Issue: 1, 23 - 35, 31.01.2026

Büşra Atsal Kılıç , Özlem Ovayolu , Sibel Serçe

https://doi.org/10.47565/ndthdt.2026.121

Abstract

Objective: This study was conducted to evaluate the effect of lidocaine gel on invasive pain during arteriovenous fistula cannulation in hemodialysis patients.
Material and Method: Prior to the study, necessary approvals were obtained from the ethics committee, the institution, and the patients. The sample size was determined through power analysis, and patients who met the inclusion criteria were randomly assigned to the intervention (n=34), and placebo (n=34) groups. Data were collected using a questionnaire, and the Visual Analog Scale (VAS). The procedure was carried out over three consecutive hemodialysis sessions, during which patients were asked to indicate their level of pain on the VAS after each needle insertion.
Results: In the intervention group, the mean pain score before the application of lidocaine gel was “4.50±3.30”. This score decreased to “3.52±2.67” after the first session, to “3.41±2.67” after the second session, and slightly increased to “3.55±2.31” after the third session (p>0.05). In the placebo group, the baseline pain score before the application of physiological saline was “4.47±3.30”, which decreased to “4.32±3.14” after the first session, “4.17±2.70” after the second session, and “3.88±2.79” after the third session (p>0.05).
Conclusion: According to the results of the study, there was no statistically significant difference in pain scores across the four repeated measurements in either the lidocaine gel, or placebo groups (p>0.05).

Keywords

Arteriovenöz Fistül , Hemodiyaliz , Lidokain Jel , Hemşirelik , Ağrı

Hemodiyaliz Hastalarında İğne Girişi Ağrısı Üzerine Lidokain Jelinin Etkisi: Randomize Kontrollü Bir Çalışma/ The Effect of Lidocaine Gel on Needle Puncture Pain in Hemodialysis Patients: A Randomized Controlled Trial

Abstract

Amaç: Bu çalışma, hemodiyaliz hastalarında arteriovenöz fistül enjeksiyonu sırasında uygulanan lidokain jelinin invaziv ağrı üzerindeki etkisini değerlendirmek amacıyla yürütülmüştür.
Gereç ve Yöntem: Çalışma öncesinde etik kurul, kurum ve hastalardan gerekli izinler alınmıştır. Örneklem büyüklüğü güç analizi ile belirlenmiş, çalışma kriterlerini karşılayan hastalar müdahale (n=34) ve plasebo (n=34) gruplarına rastgele atanmıştır. Veriler, anket formu ve Görsel Analog Skala (VAS) kullanılarak toplanmıştır. Uygulamalar üç ardışık hemodiyaliz seansı boyunca gerçekleştirilmiş, her iğne girişimi sonrasında hastalardan VAS üzerinde hissettikleri ağrı düzeyini belirtmeleri istenmiştir.
Bulgular: Müdahale grubunda, lidokain jel uygulaması öncesi ortalama ağrı skoru “4,50±3,30” iken; birinci seans sonrası “3,52±2,67”, ikinci seans sonrası “3,41±2,67”'ye düşmüş ve üçüncü seans sonrası “3,55±2,31”'e yükselmiştir (p>0,05). Plasebo grubunda ise fizyolojik tuzlu su uygulaması öncesi ortalama ağrı skoru “4,47±3,30” olup; birinci seans sonrası “4,32±3,14”, ikinci seans sonrası “4,17±2,70” ve üçüncü seans sonrası “3,88±2,79” olarak kaydedilmiştir (p>0,05).
Sonuç: Elde edilen bulgular doğrultusunda, hem lidokain jel hem de plasebo grubunda dört tekrarlı ölçümler sonucunda ağrı skorlarında istatistiksel olarak anlamlı bir fark saptanmamıştır (p>0,05).

Keywords

Arteriovenous Fistula , Hemodialysis , Lidocaine Gel , Nursing , Pain

Ethical Statement

Etik Komite Onayı: Bu çalışma için etik komite onayı, Gaziantep Üniversitesi Klinik Araştırmalar Etik Kurulu'ndan alınmıştır (Tarih ve no: 2018/241).

Supporting Institution

yok

Thanks

Araştırmaya katılan tüm hastalara ve sağlık profesyonellerine teşekkür ederiz.

References

• 1. Gulcicek S, Seyahi N. Comparison of chronic kidney disease progression and associated complications between geriatric and non-geriatric groups. Medicine (Baltimore). 2024;103(9):e37422. doi: 10.1097/MD.0000000000037422.
• 2. Yücel İ, Aydın Sayılan A. Kronik böbrek yetmezliği tanısı ve bası yarası olan bireyin Günlük Yaşam Aktiviteleri Modeli’ne göre değerlendirilmesi. Aydın Sağlık Dergisi. 2023;9(1):88-96. https://dergipark.org.tr/en/pub/asder/article/1183233
• 3. Seyahi N, Ateş K, Süleymanlar G. Current status of renal replacement therapies in Turkey: Summary of Turkish Society Nephrology Registry 2016 report. Turk Nephrol Dial Transplant. 2018;27(2):133-9. doi: 10.5262/tndt.2018.3329.
• 4. Arab V, Bagheri-Nesami M, Mousavinasab SN, Espahbodi F, Pouresmail Z. Comparison of the effects of hegu point ice massage and 2% lidocaine gel on arteriovenous fistula puncture-related pain in hemodialysis patients: A randomized controlled trial. J Caring Sci. 2017;6(2):141-51. doi: 10.15171/jcs.2017.014.
• 5. George S, Nalini M, Sarosh Kumar KK, Dsilva F, Shenoy P, Pillai SG. A Comprehensive Assessment of Pain Among Hemodialysis Patients: A Cross-sectional Study. J Health Allied Sci NU. 2025;15(4):489-93. doi: 10.25259/JHASNU_33_2025.
• 6. da Silva OM, Rigon E, Dalazen JVC, Bissoloti A. Pain during arteriovenous fistula cannulation in chronic renal patients on hemodialysis. Open J Nurs. 2016;6(12):1028-37. doi: 10.4236/ojn.2016.612098.
• 7. Ghods AA, Abforosh NH, Ghorbani R, Asgari MR. The effect of topical application of lavender essential oil on the intensity of pain caused by the insertion of dialysis needles in hemodialysis patients: A randomized clinical trial. Complement Ther Med. 2015;23(3):325-30. doi: 10.1016/j.ctim.2015.03.001.
• 8. Viecelli AK, Tong A, O'Lone E, Ju A, Hanson CS, Sautenet B, et al. Report of the standardized outcomes in nephrology-hemodialysis (SONG-HD) consensus workshop on establishing a core outcome measure for hemodialysis vascular access. Am J Kidney Dis. 2018;71(5):690-700. doi: 10.1053/j.ajkd.2017.12.003.
• 9. Fareed L, Saeed AA, Ahmed YA. Pain and anxiety during AV fistula cannulation among hemodialysis patients. Biol Clin Sci Res J. 2025;6(4):27-30. doi: 10.54112/bcsrj.v6i4.1647.
• 10. Kitamo Y, Kano T, Mishima M, Matsushita K, Yasumoto N, Nakano M, et al. Dermal patch anesthesia: pain-free puncture of blood access in hemodialysis patients. Am J Kidney Dis. 1992;20(5):489-91. doi: 10.1016/S0272-6386(12)70261-5.
• 11. Kavraz Tomar O, Ulusoy S, Pulathan Z, Kaynar K, Özkan G.. The determination of duration of survival of permanent vascular access established for hemodialysis in patients with chronic kidney failure and an investigation of the factors affecting those durations.[Internet]. 2016 [cited: 28.01.2026.] Available from: https://namikkemalmedj.com/articles/the-determination-of-duration-of-survival-of-permanent-vascular-access-established-for-hemodialysis-in-patients-with-chronic-kidney-failure-and-an-investigation-of-the-factors-affecting-those-durations.
• 12. Odabaşı D, Arı E, Ekim H. Should we use basilic vein transposition instead of prosthetic graft for creation of secondary arterio-venous fistula in hemodialysis dependent end stage renal failure patients? Turkiye Klinikleri J Cardiovasc Sci. 2011;23(2):94-102. [Internet] 2011 [cited: 28.01.2026] Available from: https://hdl.handle.net/20.500.14720/19
• 13. Fareed L, Saeed AA, Ahmed YA. Pain and anxiety during AV fistula cannulation among hemodialysis patients. Biol Clin Sci Res J. 2025;6(4):27-30. doi: 10.54112/bcsrj.v6i4.1647.
• 14. Sanlıtürk D, Ovayolu N, Kes D. (2018). Hemodiyaliz hastalarında sık karşılaşılan problemler ve çözüm önerileri. [Internet]. [cited: 28.01.2026] Available from: https://dergipark.org.tr/tr/download/article-file/418873.
• 15. İtişgen V, Kara B. Hemodiyaliz hastalarında ağrı yönetimi. [Internet]. 2016 [cited: 28.01.2026] Available from: https://dergipark.org. tr/tr/pub/hemsire/issue/34246/378593.
• 16. Kolbakır F. Vasküler giriş yolları. [Internet]. 2019 [cited: 28.01.2026] Available from: https://nefroloji.org.tr/tr/icerik/genel-5/hemodiyaliz-hemsiresi-el-kitabi-434.
• 17. Kumar M, Chawla R, Goyal M. Topical anesthesia. J Anaesthesiol Clin Pharmacol. 2015;31(4):450-456. doi: 10.4103/0970-9185.169049.
• 18. Aliasgharpour M, Abbaszadeh R, Mohammadi N, Kazemnejad A, et al. Effect of lavender aromatherapy on the pain of arteriovenous fistula puncture in patients on hemodialysis. 2016 [Internet]. [cited: 28.01.2026] Available from: https://npt.tums.ac.ir/index.php/npt/article/view/125.
• 19. Shaheen S, Arshad AR, Khattak MAK. Comparison of prilocaine/lidocaine cream with piroxicam gel for reducing pain during cannulation of arteriovenous fistula for adults undergoing haemodialysis: A randomized crossover clinical trial. J Vasc Access. 2024;25(4):1081-6. doi: 10.1177/11297298221142375.
• 20. Ibrahim R, Naim M, Premtim R. Evaluation of the pain scale during arteriovenous fistula puncture with and without lidocaine gel 2% in patients undergoing haemodialysis in Kosovo. Ann Med Surg (Lond). 2022;79:103913. doi: 10.1016/j.amsu.2022.103913.
• 21. Ozen N, Akcoban S, Tosun B. Effect of cold needle application on the arteriovenous fistula cannulation-related pain: a self-controlled, double-blind study. J Res Nurs. 2025;30(5-6):439-50. doi: 10.1177/17449871251364711.
• 22. Foji S, Roodsarabi H, Torklalebag F. Comparing the impact of lidocaine spray and ice spray on pain intensity during the catheterization of hemodialysis patients: A triple-blind clinical trial. Bull Pharm Sci. 2024;47(1):303-10. doi: 10.21608/bfsa.2024.261814.2004.
• 23. Khosravi Pour A, Hejazi S, Kameli A, Hoseini Azizi T, Armat MR, Eshghi M. Cooling spray or lidocaine spray and needle insertion pain in hemodialysis patients: an open-label cross-over randomized clinical trial. BMC Anesthesiol. 2023;23(1):69. doi: 10.1186/s12871-023-02028-w.