Comparison of two topical medications, on pain relief due to fistula cannulation in hemodialysis patients

Abstract

Patients with end stage renal failure consider the pain caused

by recurrent fistula cannulations as the most intense stress

they experience from their treatment and the biggest concern

in their lives. One of the fundamental objectives of the nursing

procedures is to relieve this pain. Therefore, this study aimed

to determine the impact of two topical medications, namely

Piroxicam and EMLA cream, on the pain caused by fistula

cannulation among hemodialysis patients. This was a clinical

trial conducted on 75 patients referring to the dialysis unit of

the Shohadaye Ashayer Hospital of Khorramabad, West of Iran,

in 2013. The patients were randomly divided into three groups:

group A (Piroxicam), group B (EMLA cream), and group C

(placebo). The data collection instrument was a questionnaire

consisting of three parts: demographic information, the visual

analog scale (VAS) for pain assessment, and a checklist for the

likely side effects of the medications. The severity of pain during

fistula cannulation was assessed in the three groups in two stages

(before and after the intervention). To analyze the data, the

Kruscal-Wallis and the Mann-Whitney statistical tests and SPSS

19 were used. The median for pain relief was obviously higher

in the EMLA cream group than in either the Piroxicam or the

placebo group and this difference was statistically significant

(p<0.001). Comparing the Piroxicam and the placebo showed

that the pain reduction median was much higher in the

Piroxicam group than the placebo group, but the difference was

not significant. The results of this study showed that the EMLA

cream is more effective than the Piroxicam gel in the reduction

of pain caused by fistula cannulation among hemodialysis

patients. Therefore, based on the results of the present study, it

can be suggested that the EMLA cream, as a simple treatment

method which can be applied by the patient himself/herself, be

used to relieve pain during fistula cannulation of hemodialysis

patients.

Keywords

• Topical medications; pain relieve; fistula cannulation; hemodialysis patients

References

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