A study to assess the effect of Cryotherapy on pain and selected Biophysiological parameters during arteriovenous fistula cannulation among patients on maintenance Haemodialysis

The current study entitled a study to assess the effect of Cryotherapy on pain and selected Biophysiological parameters during arteriovenous fistula cannulation among patients on maintenance Hemodialysis at KMCH, Coimbatore was undertaken, during the year 2010 - 2011 in partial fulfillment of the requirement for the degree of Master of Science in Nursing at KMCH College of Nursing, Coimbatore which is affiliated to Dr. M.G.R. Medical University, Chennai.

Objectives: To assess the pain intensity during Xylocaine infiltration. To determine the effect of Cryotherapy on pain and Biophysiological parameters during AV fistula cannulation. To associate the level of pain with selected demographic variables.

Design: Repeated Measures design.

Setting: Hemodialysis unit of Kovai Medical Center and Hospital, Coimbatore.

Sample: Sample size was 50.

Conceptual framework: Modified Orlando‟s Nursing process model.

Outcome measures: The demographic data was collected from the subjects. The pain intensity was measured during cannulation with Xylocaine and with Cryotherapy using Numerical Pain rating Scale. The investigator recorded the Biophysiological parameters during the procedure.

Intervention: Cold application was done prior and during cannulation over on the web between the thumb and index finger of the hand which does not have the AV fistula.

Results: The mean pain score with Xylocaine infiltration at arterial site was 4.81 and at the venous site was 4.86.There was a significant reduction in the pain score during cannulation with the application of Cryotherapy. The mean pain score during cannulation after Xylocaine at the arterial site was 1.59 and at the venous site was 1.51 whereas the mean pain score during cannulation after Cryotherapy was 0.96 and 0.92 correspondingly. But there was no statistically significant difference between the values of Biophysiological parameters such as BP, PR and RR during cannulation done with Xylocaine and with Cryotherapy. There was no significant association between pain score and age and gender of the subjects but there was significant association between pain and duration of illness and duration of treatment

Conclusion: Cryotherapy is an effective nonpharmacological measure in reducing pain during AV fistula cannulation among Hemodialysis patients.