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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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Publication Date
Tue Jun 01 2021
Journal Name
Iraqi Journal Of Physics
Use of zeolite to reduce the radioactivity of cesium -137 in the liquid waste
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 Prepared zeolite type A was used for theremoval of cesium ions from aqueous solution. The experimental data were analyzed by Langmuir, Freundlich isotherms. Various parameters, such as contact time, zeolite weight, pH, and initial concentration, were studied. The results indicated that the highest removal efficiency was95.53% at (2h time, 0.04 g weight, and pH=6.8). The results also showed that the Freundlic model fits well with the experimental results and is better than the Langmuir model.

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Publication Date
Tue Oct 10 2023
Journal Name
2023 3rd International Conference On Emerging Smart Technologies And Applications (esmarta)
Perceived Trust of Stakeholders: Predicting the Use of COBIT 2019 to Reduce Information Asymmetry
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Perceived Trust of Stakeholders: Predicting the Use of COBIT 2019 to Reduce Information Asymmetry

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Publication Date
Sun Jan 01 2023
Journal Name
Corporate Governance And Organizational Behavior Review
Impact of the electronic internal auditing based on IT governance to reduce auditing risk
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This paper analysed the effect of electronic internal auditing (EIA) based on the Control Objectives for Information and Related Technologies (COBIT) framework. Organisations must implement an up-to-date accounting information system (AIS) capable of meeting their auditing requirements. Electronic audit risk (compliance assessment, control assurance, and risk assessment) is a development by Weidenmier and Ramamoorti (2006) to improve AIS. In order to fulfil the study’s objectives, a questionnaire was prepared and distributed to a sample comprising 120 employees. The employees were financial managers, internal auditors, and workers involved in the company’s information security departments in the General Company for Electricity D

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Publication Date
Fri Oct 02 2020
Journal Name
International Journal Of Pharmaceutical Research
Effectiveness of Self-Instructional Strategy and the Traditional Teaching Approach on Nursing Students' Knowledge toward Cardiopulmonary Resuscitation at the College of Nursing in University of Baghdad: Randomized Comparative Trial
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Background: Cardiopulmonary resuscitation (CPR) is a technique or procedure that combined chest compression and rescue breathing to maintain enough circulation that prevents brain damage until other essential steps are taken to control the main cause of cardiac and respiratory arrest. The health care personnel should be qualified in the performing of cardiopulmonary resuscitation (CPR) to improve the survival rate of the victims. Therefore; it is necessary to use new methods for learning [1]. Objectives: the study aims to compare the effectiveness of self-instructional teaching strategy and traditional teaching approach on student’s knowledge toward cardiopulmonary resuscitation. Methods: A randomized comparative trial (RCT) design was ca

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Publication Date
Sun Jun 08 2025
Journal Name
Kufa Journal Of Arts
Compound thought :Or face crises from oneself to politics A Philosophical Study on the Editions of Edgar Moran
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Publication Date
Tue Nov 30 2021
Journal Name
Research Journal Of Pharmacy And Technology
Diagnostic approach to Perimenopausal bleeding by Pipelle or Dilatation and Curettage
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Perimenopausal bleeding, is a very common problem, which is an alarming symptom for both; women and their doctors because of the rising fears of cellular changes or tumor of endometrium. In our study we tried to prove that collecting endometrial samples using the outpatient method of Pipelle is as effective as collecting the endometrial samples in the traditional method of Dilation and Curettage (DandC) in operation theatre which necessitates general anesthesia. Ninety four patients more than 40 years old were included in the study, all of them were complaining of abnormal uterine bleeding (pregnant ladies and ladies using hormonal contraception were excluded from the study) and endometrial samples were collected first in outpatient

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Publication Date
Wed Apr 01 2020
Journal Name
International Journal Of Pharmaceutical Research
Effectiveness of Self-Instructional Strategy and the Traditional Teaching Approach on Nursing Students&#39; Knowledge toward Cardiopulmonary Resuscitation at the College of Nursing in University of Baghdad: Randomized Comparative Trial
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MM ABDUL-WAHHAB, SA AHMED, International Journal of Pharmaceutical Research, 2020 - Cited by 2

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Publication Date
Wed Dec 30 2015
Journal Name
Al-kindy College Medical Journal
Basilic Vein Mobilization for Brachio-Basilic Arterio-Venous Fistula in Dialysis
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Background: The first and second choice for vascular access in patients with end stage renal disease (ESRD) is radio cephalic and brachio cephalic arteriovenous fistula (AVF).In patients with failed previous AVF e or poorly visualized or impalpable cephalic veins, the basilic vein can be mobilized and superficialized to create an AVF with the brachial artery.Objective: The aim of this study is to report our experience at the Vascular Surgery Department/ Surgical Specialty Hospital in brachio-basilic (BB) vascular access for hemodialysis.Methods: From January 2006 to December 2009, 31 patients with ESRD whose cephalic veins were thrombosed or impalpable or had previous unsuccessful vascular access procedures were referred to the Vascular

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Publication Date
Sat May 01 2021
Journal Name
Chemical Engineering Research And Design
Ternary glycerol-based deep eutectic solvents: Physicochemical properties and enzymatic activity
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The present study investigates deep eutectic solvents (DESs) as potential media for enzymatic hydrolysis. A series of ternary ammonium and phosphonium-based DESs were prepared at different molar ratios by mixing with aqueous glycerol (85%). The physicochemical properties including surface tension, conductivity, density, and viscosity were measured at a temperature range of 298.15 K – 363.15 K. The eutectic points were highly influenced by the variation of temperature. The eutectic point of the choline chloride: glycerol: water (ratio of 1: 2.55: 2.28) and methyltriphenylphosphonium bromide:glycerol:water (ratio of 1: 4.25: 3.75) is 213.4 K and 255.8 K, respectively. The stability of the lipase enzyme isolated from porcine pancreas (PPL) a

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Integration of Dissolved Analysis and Total Quality Management to reduce costs and improve product quality
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there is a need to use the teardown Technique in a various fields and different motives and used often by economic units as a technique to help other techniques for example, used by some economic units for the analysis of other economic units of products in order to work on the development of products and look for opportunities to improve product quality and avoid product errors competitor or reduce its costs, in addition to the services provided by quality control is used ISO 17025 integration with unassembled analysis to adjust the quality of the product by comparing the pieces produced with designed models that are also the product as a whole compared with the original design

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