Topical arnica and mucopolysaccharide polysulfate (hirudoid) to decrease bruising and pain associated with haemodialysis cannulation - related infiltration: a pilot study

<b>ABSTRACT</b><br /><b>Background</b>: <div>Topical treatments such as Arnica cream and mucopolysaccharide polysulfuric acid (contained in Hirudoid cream) have been used to treat the bruising and pain arising from dialysis-related infiltrations.<br /><b>Aim: <br /></b>To undertake a randomised controlled pilot study comparing the efficacy of Arnica and Hirudoid creams in treating bruising and pain following post-needling infiltration.<br /><b>Methods: <br /></b>One dialysis centre of 40 patients over a 12-month period. Following infiltration, and at the five subsequent dialysis treatments, pain was measured using the Abbey pain scale and size of the bruise was recorded.<br /><b>Results: <br /></b>Eleven cases of infiltration were recorded consisting of seven males (64%) and four females (36%) who had a mean age of 78 years (SD=9). Access for eight patients was via arteriovenous fistula and for three patients via arteriovenous graft. Eight patients experienced bruising and two patients reported mild pain post-infiltration but there were no differences found between the effect of Arnica or Hirudoid in treating either symptom.<br /><b>Conclusion: <br /></b>This pilot study was unable to detect any differences in the effect of Arnica and Hirudoid on pain or bruising. The study demonstrated that a larger, multicentre trial would be required to power a study and that a non-interventional control group should be added.</div>