Cannulation pain

My husband is experiencing increasing pain in both buttonholes when being cannulated. He has been on home hemodialysis for about 4 years but only began complaining about 6 months ago. Is this common, and if so what are others doing about it?


Can you describe the pain in further detail? Is it just when the needles are bein inserted? How long does it last until it goes away? Is the pain just in the buttonhole site?

I have experienced similar pain, but more than likely due to nerves in the area. Some sticks I will barely feel anything and others I really notice it. Do you use Emla/lidocaine cream at all before the cannulation? This does help tremendously if its just when inserting the needles.

I think Stuart should be able to give you some suggestions or ideas on why this may be happening.


Thank, MM. We have tried both Emla and Lidocaine in the past but they didn’t seem to help. We are trying Lidocaine again, but wonder if we’re doing it right. Jane said she uses a plastic cover. We are using bandaging. What have you used, and how long before cannulating did you apply it? Thanks…

i use plain plastic wrap. Nice and cheap and does the job. I just place a dab where you are going to be cannulating approx 40 minutes to 1 hour before. wrap a piece of the plastic wrap around, making sure its not too tight around the fistula and use 1 or two pieces of tape to hold in place. I find for me if its any more than an hour it will start to burn the skin, but everyone is different.
When your ready, take it off and make sure you clean your site very carefully as prescribed.

I will say that once instead of Emla cream, they gave me ointment. There was a big difference as the ointment just melted away from the warmth of the skin and did not work. The ointment is like neosporin in consistency.

I will be interested in what Stuart will provide to help you. He is very experienced and should be able to provide you with further info.


Need to ask this question how often are you cannulated his buttonholes. If more than 4 times per week you are irritating the tunnel track. You need to start two new sites at least 3/4 inch up ordown for where you are buttonhole now. This will relive the pain. In about two weeks go back to your old sites and recannulated and let me know how this works out. Use antibacterial soap to remove the scabs prior to cannulation. Use hot water and than apply one drop on the buttonhole. Than use shower scrubber to remove the scab in clock ward motions to remove the scab. All that is left is a small plug the size of the buttonhole needles. Use your picker that comes with the buttonhole needles and remove the plug Apply baitadiene and wait 4-5 minis and cannulated. Where is the are the buttonholes located at upper or lower arm. If they are on the lower arm go to using the 3/5-cannulation needle