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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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Numerical Solutions for the Nonlinear PDEs of Fractional Order by Using a New Double Integral Transform with Variational Iteration Method
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Thermal Management of the Melting Process in a Latent Heat Triplex Tube Storage System Using Different Configurations of Frustum Tubes
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Abstract The aim of this study is preparing an intellectual map according to the feedback (verbally and writhingly ) in order to learn some skills of floor exercises in the women's artistic gymnastics , In addition to that the aim of this study defines on the impacts of intellectual map according to the feedback approach, and to identify the best group between the three groups study in the learning of skills approach in this study, the researchers used the experimental method, the subject of the study included on students second class in physical education and sport sciences , Baghdad University (2014-2015) , and divided into three groups for teaching skills which was under studied .The species used the specific manner by lot for selection

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Sat Dec 01 2018
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Comparison between the Methods of Ridge Regression and Liu Type to Estimate the Parameters of the Negative Binomial Regression Model Under Multicollinearity Problem by Using Simulation
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The perceptive image of volunteering and its relationship to the motives towards volunteering among a sample of Al-Quds Open University students.
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Sun Dec 15 2019
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Directorial Vision and its Relation to Scenographic Proposal in the Iraqi Theater Show- The Play of Darkness -A Model: رامي سامح زكي
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