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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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Trends of Neonatal Mortality in context of Case Overload in Al - Alwyia Pediatric Teaching Hospital at Baghdad during 2005-2012
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The Theme of the Family in Russian Literature during the "Thaw" on the Material the story of M. Sholokhov "The Fate of a Man"and the story of V. Panova "Seryozha" and F. Abramov "Fatherless".
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Tue Dec 01 2020
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Wed Oct 25 2023
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Provisions for a Muslim to be naturalized with the citizenship of non-Muslim countries
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Sun Mar 04 2012
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Land Magnetic survey along a profile from Akaz to Rutba town and its applications
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A land magnetic survey was carried out along regional profile, which is located at the north part of the Iraqi western desert. It starts from al –Qaam City (at north) toward Rutba City (at south) with a total length of 238km. The survey was carried out along the paved road between the two cities, About 113 measuring points were done with inter-station distance of 2 km (for 198 km) and 2 to 5km (for 40km). Two proton magnetometers were used in this survey. One of them is used for base station monitoring, which was fixed as of Salah Aldin field (Akkas). Its readings were used for diurnal corrections. All magnetic measurements were corrected for normal and topographic corrections. The readings were reduced to a certain base level. The resu

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