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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
Sun Mar 01 2026
Journal Name
Journal Of The Society For Cardiovascular Angiography &amp; Interventions
A Novel Strategy to Promote Equity and Access in Interventional Cardiology: Early Insights From the 2024-2025 ACC Clinical Trial Research Cohort
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Publication Date
Wed Jan 14 2026
Journal Name
Cancers
Advances in the Pathophysiology and Management of Cancer Pain: A Scoping Review
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Background/Objectives: Cancer pain affects 55–95% of patients with advanced malignancy, representing a complex syndrome involving nociceptive, neuropathic and nociplastic mechanisms. Despite therapeutic advances, two-thirds of patients with metastatic cancer experience inadequate pain control. This scoping review synthesizes recent advances in cancer pain pathophysiology and management, focusing on molecular and cellular mechanisms, emerging pharmacological, interventional and technological therapies and key evidence gaps to inform future precision-based pain management strategies. Methods: Following PRISMA-ScR methodology, we searched PubMed, Embase, Scopus, and Web of Science for studies published between January 2022 and Septem

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Publication Date
Thu Apr 03 2025
Journal Name
Journal Of The American Oil Chemists' Society
A novel deep eutectic solvent‐based liquid membrane for the extraction of glycerol from crude biodiesel
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Abstract<p>This study used deep eutectic solvent (DES) as the liquid membrane in a bulk liquid membrane system (BLM) to remove glycerol from waste cooking oil‐based biodiesel. The DES was prepared from choline chloride and tetraethylene glycol at a molar ratio of 1:5. Diethyl ether was employed as a novel strip phase for the glycerol in BLM. The effects of the DES: biodiesel ratio, stirring speed, and extraction time on the extraction and stripping efficiencies were investigated. The results showed that BLM could give better glycerol removal from biodiesel than mechanical shaking. Increasing the DES: biodiesel ratio, stirring speed, and extraction time can enhance glycerol removal from the feed phase, achievi</p> ... Show More
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Publication Date
Mon Oct 01 2018
Journal Name
International Journal Of Civil Engineering And Technology
NUMERICAL ANALYSIS OF PILES FOUNDATION TO REDUCE THE ZONE OF LIQUEFACTION OF SANDY SOIL UNDER DYNAMIC LOADS
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The major cause of destruction during vertical vibration is the failure of the soil structure. The soil may fail due to loss of strength during continues vibration. The saturated sandy soil losses strength due to an increase in pore pressure, this phenomenon is called "liquefaction". Piled foundations are usually adopted as a foundation solution in potentially liquefiable soil under dynamic loading. In this research, 3D finite element model using PLAXIS Software was employed for pile foundation in saturated sandy soil. The results show the acceleration mobilization and velocity on the footing increases with increasing the intensity of dynamic loads and it becomes zero at maximum value of vertical settlement which indicates the end of the ti

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Publication Date
Sun Jun 01 2014
Journal Name
Baghdad Science Journal
The Use of Tea leaves Wastes to reduce Hexavalent Chromium Concentration in industrial Waste Water by Adsorption
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Abstract : A research was conducted to study the process parameters affecting hexavalent chromium Cr (VI) (carcinogenic compound) the removal percentage from the electrical industries company waste water that contain 88 mg/l of Cr (VI) concentration by adsorption onto tea wastes. Synthetic water with 88 mg/l Cr (VI) concentration was used. Several operation parameters affecting Cr (VI) removal efficiency were investigated, such as pH, initial Cr (VI) concentration, stirring time and tea wastes dose. The experimental results reveal that maximum Cr (VI) removal reached up to 94.26% at pH of 2, stirring time of 180 minute, tea wastes do

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Publication Date
Mon Aug 28 2023
Journal Name
Journal Of Planner And Development
The role of environmental taxation and environmental incentives to reduce environmental pollution manifestations in the urban environment
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        The aim of studying the role of environmental taxation is to reduce or mitigate the problem of environmental pollution and obtain a clean environment. And the importance of research lies in the fact that environmental taxation is one of the basic tools to achieve environmental balance. As it is considered one of the sustainable economic tools that focuses on the concept of environmental taxes and fees. Therefore, the incentives stimulated institutions to invest in clean energy and use environmentally friendly machines. Through it, the rules of the competition are updated in favor of organizations that respect the environment so that they can obtain a green competitive advantage. And that the mai

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Publication Date
Fri Oct 01 2010
Journal Name
2010 Ieee Symposium On Industrial Electronics And Applications (isiea)
Distributed t-way test suite data generation using exhaustive search method with map and reduce framework
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Publication Date
Wed Mar 27 2013
Journal Name
Journal Of University Of Babylon
Reduce the required time for measuring the permeability of clayey soils by using new manufactured cell
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Reduce the required time for measuring the permeability of clayey soils by using new manufactured cell

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Publication Date
Tue Nov 17 2020
Journal Name
Journal Of Physics: Conference Series
A trial treatment of Hydatidosis in white mice by Immunization and Chemicals
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The present study was conducted as atrial to treat secondary hydatidosis in white mice of species Mus musculus. (Balb/c strain), experimentally infected with secondary hydatid cysts of sheep origin. The immunization process was carried by using CF/PS antigen which consist hydatid cyst fluid (CF) antigen, and protoscolices (PS) antigen mixed together and by using two concentrations 7.5, 15 mg/ml. Then derivatives of Benzimidazole, Mebendazole (M) and drugs Albendazole (A) were used 10 and 40 μm/gm body weight respectively. The mixture of drugs was used one week after challenged dose. Criteria taken into consideration to define the activity of the immunization and chemotherapy in this study were reduction in the numeral of cysts, the coeffic

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences
Preparation and Evaluation of Atenolol Floating Beads as a Controlled Delivery System
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         This study aims to encapsulate atenolol within floating alginate-ethylcellulose beads as an oral controlled-release delivery system using aqueous colloidal polymer dispersion (ACPD) method.To optimize drug entrapment efficiency and dissolution behavior of the prepared beads, different parameters of drug: polymer ratio, polymer mixture ratio, and gelling agent concentration were involved.The prepared beads were investigated with respect to their buoyancy, encapsulation efficiency, and dissolution behavior in the media: 0.1 N HCl (pH 1.2), acetate buffer (pH 4.6) and phosphate buffer (pH 6.8). The release kinetics and mechanism of the drug from the prepared beads was investigated.All prepared atenolol beads remained f

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