Introduction:
Impact of AV Fistula Needle Bevel Position in Hemodialysis Patients on Puncture Pain and Post-removal Bleeding: A Prospective Observational Study from a Tertiary Care Centre
Methods:
A single-blind crossover study was conducted on 100 patients at Saveetha Hospital, Chennai, from February to May 2024. Patients underwent eight sessions of hemodialysis: in the first four sessions, the arterial needle bevel was positioned upward, while in the subsequent four sessions, it was positioned downward. Puncture pain was measured using the Visual Analog Scale (VAS), and bleeding times were recorded following needle removal. Multivariate logistic regression analysis was used to assess the association between dialysis-related variables and needle bevel position.
Results:
The median VAS score was significantly lower when the needle bevel was oriented downward (2.25) compared to upward (4.26) (p < 0.01). Similarly, post-removal bleeding times were shorter with bevel-down insertions (2.71 minutes) compared to bevel-up insertions (3.73 minutes) (p < 0.01). Multivariate analysis showed that needle bevel-down insertion was independently associated with reduced pain (95% CI: 4.65–8.76, p < 0.011) and shorter bleeding times (95% CI: 4.65–12.88, p < 0.003).
Conclusions:
Needle bevel orientation during AVF cannulation has a significant impact on patient outcomes. Bevel-down insertion not only reduces puncture pain and post-removal bleeding time but also shows strong independent associations with these outcomes in multivariate analysis, suggesting potential benefits in patient comfort and safety during hemodialysis.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.