The Effectiveness of Nursing Interventions in Managing Arteriovenous Fistula Insertion Pain in End-Stage Renal Failure Patients Undergoing Haemodialysis: A Systematic Literature Review

Ronald Limaheluw; Shanty Wulan Insafni Ndraha; Yehezkiel Melco Pellaupessy; Magda Fiske Rumambi

doi:10.19166/ncjk.v14i1.10816

Authors

Ronald Limaheluw Faculty of Nursing, Universitas Pelita Harapan
Shanty Wulan Insafni Ndraha Faculty of Nursing, Universitas Pelita Harapan
Yehezkiel Melco Pellaupessy Faculty of Nursing, Universitas Pelita Harapan
Magda Fiske Rumambi Universitas Pelita Harapan

DOI:

https://doi.org/10.19166/ncjk.v14i1.10816

Keywords:

Arteriovenous Fistula, Methods, Pain Management, Pharmacology, Renal Dialysis

Abstract

Background: End-stage renal failure is a global health issue requiring haemodialysis as a life-sustaining therapy. The insertion of an arteriovenous (AV) fistula, the primary vascular access for haemodialysis, often causes recurrent pain, impacting patient comfort and quality of life.Objective: To identify the effectiveness pharmacological and non-pharmacological pain management interventions for AV fistula insertion before and after intervention in hemodialysis patients. Methods: To evaluate the effectiveness of pharmacological and non-pharmacological interventions for managing pain associated with AV fistula insertion in haemodialysis patients, both pre- and post-intervention. A systematic literature review was conducted using a simplified approach. Data were sourced from ScienceDirect, PubMed, EBSCO, and ProQuest databases, employing Boolean operators “AND” and “OR”. Article selection followed the PRISMA flow diagram, facilitated by the Rayyan application, with analysis conducted using the JBI Critical Appraisal Tools. Results: Lidocaine gel 2% (pharmacological intervention) and cryotherapy with ice packs applied at the Hegu point (non-pharmacological intervention) were found to be the most effective in reducing pain during AV fistula insertion. Lidocaine provides rapid local anaesthesia with minimal side effects, while cryotherapy, a non-invasive method, effectively reduces pain perception through sensory nerve stimulation. Conclusion: Pain management for AV fistula insertion is effectively achieved through both pharmacological and non-pharmacological approaches, with non-pharmacological interventions demonstrating more consistent effectiveness.

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