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Arnica is a medicinal plant of the species Arnica montana, endemic in Central and Southern Europe. It belongs to the Asteracae family and is rich in flavonoids and phenolic compounds, lactones, helenalin and hexuronic acid. These compounds have been traditionally believed to have anti-inflammatory properties, and arnica has been used topically to soothe and alleviate bruises, sprains, and muscle aches. It's available in various forms, including creams, ointments, and gels .
We retrospectively analyzed the use of arnica in 8 patients with end-stage chronic kidney disease , undergoing hemodialysis treatment. They were all women, with an average age of 64 years. They were treated over a period of 7 days in our Hemodialysis Unit for presenting deep hematomas as a result of failed punctures of their vascular access. All were on hemodialysis treatment for three weeks and four hours at a time.
Arnica gel was used as a complementary therapy to conventional treatment that consisted of local cold with ice and oral analgesics and anti-inflammatories.
The arnica gel was applied topically three times a day, with a coverage of 1 mm, non-occlusive, on healthy skin, without rubbing.
Pain was assessed with a verbal numerical rating scale from 0 to 10, three times. The first time was on the pretreatment day when the hematoma occurred, then we performed the evaluation on days three and seven.
A qualitative analysis was performed with photographic recording of day zero, day three and day 7 to evaluate hematoma resorption and edema(Figure1).
Rapid pain relief and hematoma resorption were observed between the third and seventh day in all patients . According to the verbal analogue scale, on day 0 : 100% reported pain 10/10, which was reduced by 50% to 5 points after three days and reached a score of zero on the seventh day.
Treatment with arnica allowed these patients to continue their hemodialysis treatment using the arteriovenous fistula, without the need for the use of a temporary catheter. In addition, comfort and trust was generated towards the nursing team that assisted them.