Hegu point acupressure for cannulation pain across fistula sites: Randomized controlled trial

Cannulation-related pain is a common problem in hemodialysis patients with arteriovenous fistulas (AVFs). Identifying effective non-pharmacological strategies, such as Hegu (LI4) point acupressure, may help improve patient comfort. This study examined the effect of Hegu point acupressure on cannulation-related pain in hemodialysis patients with AVFs located in different anatomical regions.

This randomized controlled study included 131 hemodialysis patients at a university dialysis center between October 2022 and February 2023. Patients had AVFs in antecubital, Brescia-Cimino, or snuff-box regions and were randomly assigned to intervention or control groups. The intervention consisted of three minutes of Hegu acupressure before cannulation, applied across three consecutive dialysis sessions. Pain intensity during needle insertion was assessed with the Numerical Rating Scale. Control patients received routine care. Data were analyzed using mixed-design ANOVA, and effect sizes were calculated with Cohen's d.

Pain scores in intervention groups decreased significantly across all fistula sites, with the most pronounced reduction in the Brescia-Cimino site (from 2.18 ± 0.95 to 0.81 ± 0.20). Decreases were also observed in the antecubital (from 2.14 ± 1.08 to 1.13 ± 0.46) and snuff-box sites (from 1.82 ± 0.13 to 1.09 ± 0.86). In contrast, pain scores in control groups remained stable or increased. Group and time interaction effects were significant across all sites (p < 0.05), with large effect sizes favoring acupressure.

Hegu point acupressure reduced cannulation pain in patients with AVFs at different anatomical sites, with the strongest effect in the Brescia-Cimino region.