Comparing the effect of cold and warm stimulation of Hoku point on pain Caused by Removal of External Fixators pin in patients with hand fractures

Background: One of the most common complaints in patients during the pin is removed from the metacarpal bone fracture is pain. Topical warm and cold therapy have effects on the skin, so that it can relieve pain. On the other hand, according to traditional Chinese medicine, the Hoku point is the most important pain point in the body. The aim of this study was to compare the effect of cold and warm stimulation of Hoku point on pain Caused by Removal of External Fixators pin in patients with hand fractures. Methods: This randomized clinical trial study was performed on 109 patients with metacarpal finger fracture with external pin referring to emergency department of Shahid Beheshti Hospital in Kashan at 2019. Patients were divided into three groups through block randomization: Huko point massage with ice, Huko point massage with warm compress and routine care. The Hoku point massage was done for 10 minutes before the pin was removed. Patients' pain severity was measured by McGill pain questionnaire immediately after remove of pin in all three groups. Data were analyzed using Chi-square test and one-way ANOVA. Results: The mean total pain score in the Huko point stimulation group with warm compress, ice, and routine care was 65/33±1/50, 31/21±5/21 and 42/30±4/93, respectively. The results of one-way ANOVA showed a significant difference in terms of overall pain between the three groups (p<0.001).Post hoc test showed that the mean score of all pain and its dimensions were significantly lower in the cold-stimulated Hoku point group than in the other two groups and in the Hoku-stimulated point-warm group significantly lower than the control group ( p<0.001). Conclusion: Cold-stimulated Hoku point stimulation significantly attenuated pain due to external pin removal in patients with fractures compared to Hoku-stimulated point-warm or routine care. Therefore, considering the cheapness, applicability and safety of this method, it is recommended to plan nurses' training in applying alternative medicine approaches including stimulation of Hoku point.