title: Pain degree and skin damage during arterio-venous fistula puncture.
abstract: The aims of this study were to evaluate the effect of needle bevel position on the degree of pain and damage to the skin covering the vein, in an arteriovenous fistula puncture, in haemodialysis patients. 48 patients with autologous arteriovenous fistula were studied. After puncture the patient was asked about the degree of pain perceived by means of an analogue visual scale and a descriptive verbal scale. When the needle was removed, the length of the cut made by the puncture was measured. The perceived pain assessed by analogue visual scale was greatest when the needle was punctured with the bevel facing upwards rather than downwards (median: 3 versus 2, p<0.003). The prick in the skin was greater when the puncture was made with the bevel facing upwards (19.7 +/- 5.6) rather than downwards (16.2 +/- 3.8, p<0.0001). It is concluded that arteriovenous fistula puncture with the bevel facing downward significantly reduces the degree of pain and the skin lesion at the point of puncture, without increasing the number of punctures.
authors.affiliation: Nephrology Service, Reina Sofía University Hospital, Córdoba, Spain. rcrespom@medynet.com
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Crespo Montero
authors.forename: Flora
authors.initials: F
authors.lastname: Rivero Arellano
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Contreras Abad
authors.forename: Angela
authors.initials: A
authors.lastname: Martínez Gómez
authors.forename: María Isabel
authors.initials: MI
authors.lastname: Fuentes Galán
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical; D006801:Humans; D008875:Middle Aged; D009339:Needles; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D018962:Phlebotomy / Q000009:adverse effects* / Q000379:methods*; D006435:Renal Dialysis; D012867:Skin / Q000293:injuries*; D018709:Statistics, Nonparametric