Health and Medical Psychology Health and Medical Humanities

Which Intervention is Most Effective? Rhythmic Breathing, Hugo Point Acupressure, and Vapocoolant Spray for Pain Relief During Needle Insertion in Hemodialysis Patients: A Randomized Controlled Trial

https://doi.org/10.61838/ijbmc.v12i6.956
Hemodialysis Pain Management Vapocoolant Spray Rhythmic Breathing Arteriovenous Fistula

Authors

  • Hassan Raysan Al-Waeli
    Hasan.band2302m@conursing.uobaghdad.edu.iq
    Dhi Qar Health Directorate, Ministry of Health, Dhi Qar, Iraq.
  • Wafaa Abd Ali Hattab Associated Professor, Adult Nursing Department, College of Nursing, University of Baghdad, Baghdad, Iraq.
Vol. 12 No. 6 (2025): September
Quantitative Study(ies)

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Objective: Pain from needle insertion during hemodialysis is a common challenge that requires effective pain management to ensure patient comfort. This study aimed to compare the efficacy of three pain management techniques (rhythmic breathing, Hugo Point acupressure, and vapocoolant spray) on pain intensity during needle insertion in hemodialysis patients.

Methods and Materials: A randomized controlled trial was conducted from December 4, 2024, to January 16, 2025 in Iraq, involving 120 hemodialysis patients. Participants were randomly assigned to one of four groups: control (n=34), rhythmic breathing (n=24), Hugo Point acupressure (n=35), and vapocoolant spray (n=27). Pain intensity was assessed immediately after needle insertion using the Visual Analog Scale (VAS). The rhythmic breathing group practiced controlled breathing exercises 2 minutes before and during needle insertion, the Hugo Point acupressure group received acupressure 2 minutes before and during needle insertion, and the vapocoolant spray group received a brief application of the spray prior to the procedure. Data were analyzed using SPSS version 27, employing the Mann-Whitney U test, Kruskal-Wallis H test, one-way ANOVA, Pearson correlation, and Spearman correlation.

Findings: The mean pain intensity scores were highest in the control group (64.79 ± 15.8), followed by the rhythmic breathing group (37.79 ± 4.293), the Hugo Point acupressure group (33.14 ± 4.264), and the vapocoolant spray group (25.59 ± 3.6). All three interventions significantly reduced pain intensity compared to the control group (P < 0.001). The vapocoolant spray demonstrated the most significant pain reduction, followed by Hugo Point acupressure and rhythmic breathing (P < 0.001). Additionally, Hugo Point acupressure was significantly more effective than rhythmic breathing in reducing pain intensity (P < 0.001).

Conclusion: The findings indicate that rhythmic breathing, Hugo Point acupressure, and vapocoolant spray are all effective in reducing pain during needle insertion in hemodialysis patients. However, vapocoolant spray emerged as the most effective intervention, followed by Hugo Point acupressure and rhythmic breathing. These results suggest that vapocoolant spray should be considered the preferred pain management option, with Hugo Point acupressure as a secondary alternative and rhythmic breathing as a viable option for patients who may not tolerate or have access to the other interventions.