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IRhAiJQBVTCNdQwCMhzX
Using cryotherapy, <scp>EMLA</scp> (eutectic lidocaine/prilocaine) cream, or lidocaine spray to reduce pain during arteriovenous fistula puncture: A randomized controlled trial
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Abstract<sec><title>Introduction

In hemodialysis patients, pain associated with needle insertion into an arteriovenous fistula is a physical and psychological problem. The aim of this study was to assess the effectiveness of pre‐puncture application of an ice pack, EMLA cream, or lidocaine spray to reduce pain associated with access puncture.

Methods

This was a multicenter study done in nine hemodialysis centers in Iraq. The study utilized a randomized, parallel‐group design, in which patients being dialyzed using an arteriovenous access were allocated into one of four groups. Access puncture was preceded by nothing (control group), by use of ice pack cooling at the puncture site, by application of EMLA cream, or by application of lidocaine spray. Pain after access puncture was assessed during a single treatment for each patient. Pain was quantified using a Visual Analogue Scale.

Findings

A total of 1548 patients agreed to participate, and 1041 patients were included in the data analysis. Use of an ice pack, EMLA cream, or lidocaine spray each was associated with a lower pain score on access puncture compared with no pretreatment. The mean Visual Analogue Scores in the four groups were: 69.7 ± 15.7 in the controls, 39.8 ± 13.2 in the ice pack group, 45 ± 18.4 in the EMLA group, and 52.9 ± 15.2 in lidocaine group. Ranking of the pain severity scores suggested that ice pack use was associated with the least pain, followed by use of EMLA cream and use of lidocaine spray (severity score ranking, from lowest to highest, being 1.62, 2.18, and 2.63, respectively).

Discussion

Application of an ice pack prior to vascular access puncture is a fast and inexpensive technique to limit pain associated with this procedure.

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Tue Apr 09 2019
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Publication Date
Wed Jan 30 2019
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Publication Date
Tue Dec 29 2020
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The role of the external auditor in assessing the security of information technology systems in light of (ISO/IEC 27001): (Applied research on a sample of private banks)
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Wed Jun 07 2023
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Wed Dec 15 2021
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The communicative education of fine arts in the COVID-19 crisis and its manifestations in the modernization of the works of the Iraqi painter "Nabil Ali as a model"
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Mon Jul 21 2025
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Publication Date
Sun Mar 01 2020
Journal Name
Fisheries &amp; Aquatic Life
Directional fluctuating asymmetry in certain morphological characters as a pollution indicator: Tigris catfish (<i>Silurus triostegus</i>) collected from the Euphrates, Tigris, and Shatt al-Arab Rivers in Iraq
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Abstract<p>The relationship between pollution levels in river sediment and fluctuating asymmetry of resident silurid fish species, <italic>Silurus triostegus</italic> Heckel, was assessed. Eight bilateral body proportions were analyzed in 1,500 fish from eight river locations. Sediment pollution was measured based on the analysis of heavy metals (Cd, Cr, Cu, Ni, Pb and Zn) and organochlorine pesticides (DDT, DDD, DDE, chlordane, dieldrin, and lindane). The mean quotient approach (mERMq) was used to characterize sediment toxicity, which ranged from low to moderate levels for heavy metals and from low to severe for organochlorides. Variation was noted in the measurements of fish body mor</p> ... Show More
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