Rhythmic Breathing Combined with Hugo Point Acupressure versus Vapocoolant Spray on Pain Intensity during Needle Insertion into Arteriovenous Fistula in Haemodialysis Patients: A Randomised Controlled Trial.

Patients undergoing hemodialysis face repeated needle insertions into their arteriovenous fistula, which can cause significant pain. Researchers in Iraq tested different methods to reduce this pain during needle insertion, comparing acupressure at the Hugo point (a specific pressure point on the hand) combined with rhythmic breathing against a commonly used vapocoolant spray. The study included 157 hemodialysis patients divided into five groups: a control group receiving no pain intervention, rhythmic breathing alone, Hugo point acupressure alone, both techniques combined, and vapocoolant spray. Pain was measured immediately after needle insertion using a standard pain scale. Patients in the control group experienced the highest pain levels (average score 64.79 out of 100). All interventions significantly reduced pain compared to no treatment. Rhythmic breathing alone reduced pain to 37.79, while Hugo point acupressure alone achieved 33.14. The combination of rhythmic breathing and acupressure was even more effective at 28.35, and vapocoolant spray scored 25.59. Importantly, the combination approach worked nearly as well as the vapocoolant spray, with no statistically significant difference between them. This finding is particularly valuable because the acupressure and breathing combination is non-invasive, has no side effects, and can be used in settings where vapocoolant spray isn't available or suitable for certain patients. For hemodialysis patients seeking to minimize needle insertion pain, combining Hugo point acupressure with rhythmic breathing offers an effective, accessible option. If you're interested in learning acupressure techniques for pain management, consult with a qualified acupuncturist or integrative medicine practitioner.

This randomized controlled trial (n=157) conducted in Iraq evaluated pain reduction during arteriovenous fistula needle insertion in hemodialysis patients. Five groups were compared: control, rhythmic breathing alone, Hugo point acupressure alone, combined rhythmic breathing with acupressure, and vapocoolant spray. Pain intensity was measured using Visual Analogue Scale immediately post-insertion. Results demonstrated all interventions significantly reduced pain versus control (P<0.001). Mean pain scores: control 64.79, rhythmic breathing 37.79, Hugo point acupressure 33.14, combination 28.35, vapocoolant spray 25.59. The combination intervention proved superior to single modalities (P<0.001) and statistically equivalent to vapocoolant spray (P>0.05). Clinical implications suggest Hugo point acupressure combined with rhythmic breathing provides a non-pharmacological, cost-effective alternative for procedural pain management in dialysis settings, particularly valuable in resource-limited environments or for patients with contraindications to topical anesthetics. The synergistic effect of combined interventions warrants integration into standard dialysis care protocols.