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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
Thu Sep 01 2016
Journal Name
Revista Brasileira De Zootecnia
Effect of using insect larvae meal as a complete protein source on quality and productivity characteristics of laying hens
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Publication Date
Sun Jul 01 2018
Journal Name
Computers &amp; Mathematics With Applications
Analytical and numerical solutions for the nonlinear Burgers and advection–diffusion equations by using a semi-analytical iterative method
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Publication Date
Sun Oct 01 2023
Journal Name
Applied Sciences
Multiobjective Optimization of Stereolithography for Dental Bridge Based on a Simple Shape Model Using Taguchi and Response Surface Methods
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Stereolithography (SLA) has become an essential photocuring 3D printing process for producing parts of complex shapes from photosensitive resin exposed to UV light. The selection of the best printing parameters for good accuracy and surface quality can be further complicated by the geometric complexity of the models. This work introduces multiobjective optimization of SLA printing of 3D dental bridges based on simple CAD objects. The effect of the best combination of a low-cost resin 3D printer’s machine parameter settings, namely normal exposure time, bottom exposure time and bottom layers for less dimensional deviation and surface roughness, was studied. A multiobjective optimization method was utilized, combining the Taguchi me

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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
Thu May 08 2025
Journal Name
Asian Journal Of Advanced Research And Reports
Green Chemistry Strategies to Enhance the Thermal Stability of PVC: A State-of-the-Art Overview on Plant Oil-Derived Stabilizers
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Polyvinyl chloride (PVC) finds use in various industries due to its versatility but is not thermostable, serving as a barrier to causing degradation and release of hydrochloric acid (HCl) under heat stress conditions. Lead and organotin compounds have traditionally been used for stabilizer purpose to discourage such degradation but pose serious ecological as well as health risks. As a counter measure, bio-based stabilizers from plant oils have become popular as a green and sustainable alternative. This review looks back at recent developments in plant oil-based stabilizers for PVC, focusing on the mechanisms of stabilization, sustainability, and cost-effectiveness. We review plant oils such as tung oil, castor oil, and soybean oil,

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Publication Date
Sat Sep 30 2023
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Evaluation of Investment Decisions in the health sector according to a strategic: Case study in Amir al-Mu'minin Specialized Hospital Approach
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                  The current study aims to apply the methods of evaluating investment decisions to extract the highest value and reduce the economic and environmental costs of the health sector according to the strategy.In order to achieve the objectives of the study, the researcher relied on the deductive approach in the theoretical aspect by collecting sources and previous studies. He also used the applied practical approach, relying on the data and reports of Amir almuminin Hospital for the period (2017-2031) for the purpose of evaluating investment decisions in the hospital. A set of conclusions, the most important of which is: The failure to apply

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Publication Date
Fri Jan 13 2023
Journal Name
World Academy Of Sciences Journal
Potential effects of miR‑146 expression in relation to malondialdehyde as a biomarker for oxidative damage in patients with breast cancer
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Publication Date
Tue Nov 16 2021
Journal Name
Eurasian Chemical Communications
The role of metalloendopeptidase (MEP) as a vital predictor of early diabetic nephropathy and its relationship to some other biochemical variables
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Metalloendo peptidase is a neutral endopeptidase that cleaves peptides at the amino side of hydrophobic residues and inactivates several peptide hormones, including atrial natriuretic factor, giucagon, enkephalin, substance p, neurotensin, oxytocin, and bradykinin. It is also a major enzyme for the degradation of beta-amyloid. This study aimed to measure enzyme activity and compare it with other biochemical changes in sera patients with diabetic nephropathy. The study included 35 pathological samples of people with diabetic nephropathy, 24 samples from males and 11 samples from females, as well as the same number of healthy people as a comparison group of 15 males, 20 females, with the ages of both groups of patients with diabetic nephropat

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Publication Date
Tue Jul 08 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Salivary tumor marker CA15-3 and selected elements in relation to oral health status among a group of breast cancer women
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Background: Breast cancer is the commonest type of malignancy worldwide and in Iraq. It is a serious disease that affects the general health and cause systemic changes that affect the physical and chemical properties of saliva leading to adverse effects on oral health. This study was conducted toassess the tumor marker CA15-3 and selected elements in saliva and their relation to oral health status among breast cancer patients compared to control group. Materials and Methods: The total sample consisted of 60 women aged 35-45 years. 30 women were newly diagnosed with breast cancer before taking any treatment and surgery (study group) and 30 women without clinical signs and symptoms of breast cancer as a control group. Dental caries was record

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Publication Date
Thu Aug 01 2024
Journal Name
Iop Conference Series: Earth And Environmental Science
Combining Bourgoyne and Young Equations by Bagging Tree Regression to Predict Rate of Penetration in a Southern Iraqi Field, Case Study
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Abstract<p>Achieving an accurate and optimal rate of penetration (ROP) is critical for a cost-effective and safe drilling operation. While different techniques have been used to achieve this goal, each approach has limitations, prompting researchers to seek solutions. This study’s objective is to conduct the strategy of combining the Bourgoyne and Young (BYM) ROP equations with Bagging Tree regression in a southern Iraqi field. Although BYM equations are commonly used and widespread to estimate drilling rates, they need more specific drilling parameters to capture different ROP complexities. The Bagging Tree algorithm, a random forest variant, addresses these limitations by blending domain kno</p> ... Show More
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