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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 Oct 14 2025
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Illness Perceptions and Response to Treatment with Romiplostim in Iraqi Patients with Refractory Immune Thrombocytopenia Purpura: A Cross-Sectional Study
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Background: Immune thrombocytopenia is an immune-related disorder that causes an impairment in platelet production and stimulates platelet destruction, causing variable bleeding symptoms. Objective: This study focuses on refractory immune thrombocytopenic purpura patients on romiplostim treatment and their level of illness perception related to treatment response. Method: A cross-sectional study was conducted from May 1st, 2025, to August 1st, 2025. Brief Illness Perception Questionnaires were administered to 84 patients with ITP to collect the data. The study took place at the Hematology and Bone Marrow Transplant Center, Medical City, Baghdad, Iraq. Results: The romiplostim response rate is 21 (25.0%), while the partial response rate is 4

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Publication Date
Tue Jan 31 2017
Journal Name
Journal Of Engineering
Determine an Equation to Calculate the Annual Maintenance Cost for Public Hospitals (Al Sader City Hospital as a Case Study)
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Maintenance of  hospital buildings and its management are regarded as an important subject which needs attention because hospital buildings are service institutions which are very important to a society, requiring the search for the best procedure to develop maintenance in hospitals. The research is aimed to determine an equation to estimate the annual maintenance cost for public hospital. To achieve this aim, Al-Sader City Hospital maintenance system in Al-Najaf province has been studied with its main elements through survey of data, records and reports relating to maintenance during the years of the study 2008-2014 and to identify the strengths, weaknesses, opportunities and threat points in the current system through Swat analysi

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Publication Date
Wed May 18 2016
Journal Name
Al-academy
The Role of T.V. Shaws in Transmitting Violence in Children: An Analytic Study for T.V. Chanels for Children During 1/3/2014 – 1/9/2014: يوسف محمد حسين
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Our study comes up to clarify the role of television in spreading the culture of violence with a child. This study represents one of the important studies that have tried to highlight the impact of these programmes, particularly cartoons, on the child's behaviors, actions and acquired habits.Violence considers a common phenomenon among the people, as the role of the media, particularly TV has a vital role due to its properties, characteristics and its significant impact on different segments and groups in society and in children particularly through exposure to programmes of films.The results of the study have been affected by the rising proportion of females to males, and that the contribution of real life has a big role in the child ac

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Publication Date
Sun May 01 2022
Journal Name
Journal Of Ecological Engineering
Ability of Response Surface Methodology to Optimize Photocatalytic Degradation of Amoxicillin from Aqueous Solutions Using Immobilized TiO&lt;sub&gt;2&lt;/sub&gt;/Sand
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Publication Date
Thu Nov 20 2025
Journal Name
Journal Of Physical Education
The Effect of Special Exercises Using with Assisting Aids According to Differentiated Learning (Visual Learners) in Learning Crescent Kick in Fighters of Specialized Taekwondo schools
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Publication Date
Tue Jan 01 2013
Journal Name
Iraqi Journal Of Science
Using of Remote Sensing Technique to Monitor The Status of The Plant and Change Detection for Three Different Periods in Western Region in Baghdad/ Iraq
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Data of multispectral satellite image (Landsat- 5 and Landsat-7) was used to monitoring the case of study area in the agricultural (extension and plant density), using ArcGIS program by the method of analysis (Soil adjusted vegetative Index). The data covers the selected area at west of Baghdad Government with a part of the Anbar and Karbala Government. Satellite image taken during the years 1990, 2001 and 2007. The scene of Satellite Image is consists of seven of spectral band for each satellite, Landsat-5(TM) thematic mapper for the year 1990, as well as satellite Landsat-7 (ETM+) Enhancement thematic mapper for the year 2001 and 2007. The results showed that in the period from 1990 to 2001 decreased land area exposed (bare) and increased

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Publication Date
Wed Mar 12 2025
Journal Name
The Alarba'een Journal
Analyzing and tracking the data of the millions sized gatherings for the Arba'in visit and proposing alternative ways to relieve congestion using spatial analysis algorithms
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The city of Karbala is one of the most important holy places for visitors and pilgrims from the Islamic faith, especially through the Arabian visit, when crowds of millions gather to commemorate the martyrdom of Imam Hussein. Offering services and medical treatments during this time is very important, especially when the crowds head to their destination (the holy shrine of Imam Hussein (a.s)). In recent years, the Arba'in visit has witnessed an obvious growth in the number of participants. The biggest challenge is the health risks, and the preventive measures for both organizers and visitors. Researchers identified various challenges and factors to facilitating the Arba'in visit. The purpose of this research is to deal with the religious an

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Using Regression Analysis as Analytical Procedure to Facilitate the Decision-Making Process in The Tax Audit: An Applied Research in the General Commission of Taxes
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This research aims to clarify the advantages of using the regression method as analytical procedure in the tax audit to reducing the examination cost , time, effort, human and material resources, and represents an applied study in the General Commission of taxes. In order to achieve its objectives the research has used in the theoretical side the descriptive approach (analytical), and in the practical side regression method has been applied to the research sample represented by the soft drinks company that is subject to the tax settlement for the year 2014, where the value of sales has been verified by using the regression method without conductinga comprehensive examination. The most important results of the research indicate that the r

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Publication Date
Sun Mar 01 2015
Journal Name
Baghdad Science Journal
A study of adsorption isotherms for the removal of herbicide Atlantis WG from aqueous solutions by using Bentonite clay
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The subject of this research involves studying adsorption to removal herbicide Atlantis WG from aqueous solutions by bentonite clay. The equilibrium concentration have been determined spectra photometry by using UV-Vis spectrophotometer. The experimental equilibrium sorption data were analyzed by two widely, Langmuir and Freundlish isotherm models. The Langmuir model gave a better fit than Freundlich model The adsorption amount of (Atlantis WG) increased when the temperature and pH decreased. The thermodynamic parameters like ?G, ?H, and ?S have been calculated from the effect of temperature on adsorption process, is exothermic. The kinetic of adsorption process was studied depending on Lagergren ,Morris ? Weber and Rauschenberg equati

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Publication Date
Fri Dec 01 2023
Journal Name
Al-khwarizmi Engineering Journal
The Remediation of Congo Red-Contaminated Groundwater by using a Permeable Reactive Barrier Through Modified Waterworks Sludge MgAl-LDH
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This investigation aims to explore the potential of waterworks sludge (WS), low-cost byproduct of water treatment processes, as a sorbent for removing Congo Red (CR) dyes. This will be achieved by precipitating nano-sized (MgAl-LDH)-layered double hydroxide onto the surface of the sludge. The efficiency of utilizing MgAl-LDH to modify waterworks sludge (MWS) for use in permeable reactive barrier technology was confirmed through analysis with Fourier transform infrared and X-ray diffraction. The isotherm model was employed to elucidate the adsorption mechanisms involved in the process. Furthermore, the COMSOL model was utilized to establish a continuous testing model for the analysis of contaminant transport under diverse conditions.

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