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

Hemodialysis patients who receive treatment through an arteriovenous fistula (AVF) often experience significant pain when needles are inserted into their access site multiple times per week. Researchers investigated whether applying pressure to a specific acupuncture point could reduce this discomfort. The study enrolled 131 hemodialysis patients in Turkey and tested acupressure applied to the Hegu point (LI4), located on the hand between the thumb and index finger. Patients were randomly assigned to receive either three minutes of Hegu point acupressure before needle insertion or standard care without acupressure. The intervention was applied across three consecutive dialysis sessions, and pain levels were measured using a standard numerical scale. The results showed that acupressure significantly reduced cannulation pain across all three types of fistula locations tested. The most dramatic improvement occurred in patients with Brescia-Cimino fistulas (located at the wrist), where pain scores dropped from an average of 2.18 to just 0.81 out of 10. Patients with antecubital fistulas (located at the elbow) and snuff-box fistulas (on the hand) also experienced meaningful pain reduction. In contrast, patients who received standard care without acupressure showed no improvement, and some even reported increased pain over time. For hemodialysis patients struggling with needle insertion pain, Hegu point acupressure appears to be a simple, non-invasive technique that can provide real relief without medication or side effects. If you're interested in trying acupressure for dialysis-related pain, consult with a licensed acupuncturist or trained healthcare provider familiar with this technique.

This randomized controlled trial (n=131) evaluated Hegu (LI4) point acupressure for reducing cannulation pain in hemodialysis patients with arteriovenous fistulas across three anatomical sites: antecubital, Brescia-Cimino, and snuff-box regions. The intervention consisted of three minutes of acupressure applied before needle insertion across three consecutive dialysis sessions. Pain intensity was measured using the Numerical Rating Scale. Mixed-design ANOVA revealed significant group-by-time interactions (p<0.05) across all fistula sites, with large effect sizes (Cohen's d) favoring the intervention. The most substantial reduction occurred in the Brescia-Cimino group (2.18±0.95 to 0.81±0.20), followed by antecubital (2.14±1.08 to 1.13±0.46) and snuff-box sites (1.82±0.13 to 1.09±0.86). Control groups showed stable or increased pain scores. Clinical takeaway: Hegu acupressure represents an evidence-based, non-pharmacological intervention for procedural pain management in dialysis settings, with consistent efficacy across different AVF locations.