Uso de la ecografía como apoyo de la técnica de redireccionamiento de la aguja en el dolor de la fistula arteriovenosa durante la hemodiálisis

Abstract

There is no doubt that vascular access is not only one of the key elements for carrying out renal replacement treatment with haemodialysis but also represents one of the main causes of morbidity, hospitalisation and cost in patients treated with this technique. Arteriovenous fistula remains the vascular access of choice. The fact that the patient visits at least three times a week for treatment makes the fistula puncture technique one of the most relevant factors influencing survival and, therefore, the quality of life of the patient1,2. Problems related to the technique include a wide range of setbacks (difficult channelling, high venous pressure, high recirculation, low flow, presence and aspiration of clots, prolonged haemostasis, etc.) with pain being a very prevalent event3. Despite the fact that many health-related quality of life studies analyse patient pain in haemodialysis, vascular access is rarely referred to as an independent variable and those that do, only refer to chronic pain or to the time of puncture4. However, one of the events that generates the greatest anxiety and discomfort to the patient is the pain produced during the session related to the position of the puncture needles. Therefore, the aim of this study is to present a case study describing the use of ultrasound for the management of pain in arteriovenous fistula