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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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Mon Jan 01 2024
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Lecture Notes In Mechanical Engineering
Development and Validation of a Free Piston Engine Linear Generator Simulation Model Including Cycle-To-Cycle Variation and Ignition Timing Sub-Models
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Mon Jun 14 2021
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Turkish Journal Of Physiotherapy And Rehabilitation
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One of the most important phenomena facing the athlete is the anxiety of sports competition, as he faces many psychological problems during training and in competitions of psychological tension, fear and anxiety that accompany him sometimes, which leads to affecting his level, and sports competition anxiety is a special type of anxiety that occurs in the athlete It is related to the attitudes of sports competitions and that participation in sports competitions and the associated emotional experiences are among the important factors that motivate the practice of sports activity and try to advance and develop his sports level. It is assumed that when the individual begins to practice any activity, he aims to reach a level or degree of achie

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Mon Feb 18 2019
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Journal Of Accounting And Financial Studies ( Jafs )
Auditing Quality According To Artificial Intelligence: Applied Research on A Sample of Regulatory Bodies Working In The Federal Board of Supreme Audit
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Publication Date
Sat Feb 09 2019
Journal Name
Journal Of The College Of Education For Women
Dilemmas in teaching human rights and democracy between the current realityand the difficulties in seeking to spread a culture of human rights
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Publication Date
Mon Jun 01 2009
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Simulation of material requirements planning system According to FOQ, EOQ, L4L A study in the General Company for woolen industries / blankets factory
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Publication Date
Tue Feb 26 2019
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Journal Of Accounting And Financial Studies ( Jafs )
Role Lean Accounting in Support Corporate Governance to Achieve a Competitive Advantage: An Application Study in Diala State Company for Electrical industrial
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Publication Date
Wed Jul 09 2025
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A study to compare the cleaning efficiency of different irrigation systems for macro debris removal in instrumented canals (An in vitro study)
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Background: Irrigation of the canal system permits removal of residual tissue in the canal anatomy that cannot be reached by instrumentation of the main canals so the aim of this study was to compare and evaluate the efficiency of conventional irrigation system, endoactivator sonic irrigation system,P5 Newtron Satelec passive ultrasonic irrigation and Endovac irrigation system in removing of dentin debris at three levels of root canals and to compare the percentage of dentin debris among the three levels for each irrigation system. Materials and methods: Forty extracted premolars with approximately straight single root canals were randomly distributed into 4 tested groups of 10 teeth each. All canals were prepared with Protaper Universal ha

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Publication Date
Mon Feb 28 2022
Journal Name
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Social Support and Its Relationship to Psychological Rigidity in a Sample of Breast Cancer Patients In the Ramallah and Al-Bireh Governorate
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This study aims to identify the impact of social support on breast cancer patients’ psychological rigidity using a sample in Ramallah and al-Bireh. A descriptive correlative approach was adopted to fulfill the goals of the study and a questionnaire consisted of two criteria: social support and psychological rigidity, which was adopted as a tool for data collection for the study. In order to achieve the goals of the study, the researcher selected a convenient sample that consisted of 123 female breast cancer patients in Ramallah and al-Bireh. This sample represented 50% of the original patient population. The study showed that the average estimated percentage of social support and psychological rigidity for women with breast cancer, in

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Thu Jan 25 2024
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Enhancing the therapeutic potential of curcumin: a novel nanoformulation for targeted anticancer therapy to colorectal cancer with reduced miR20a and miR21 expression
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Abstract<p>Curcumin (Cur) possesses remarkable pharmacological properties, including cardioprotective, neuroprotective, antimicrobial, and anticancer activities. However, the utilization of Cur in pharmaceuticals faces constraints owing to its inadequate water solubility and limited bioavailability. To overcome these hurdles, there has been notable focus on exploring innovative formulations, with nanobiotechnology emerging as a promising avenue to enhance the therapeutic effectiveness of these complex compounds. We report a novel safe, effective method for improving the incorporation of anticancer curcumin to induce apoptosis by reducing the expression levels of miR20a and miR21. The established</p> ... Show More
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Publication Date
Wed Jul 09 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Dental arches dimensions, forms and its association to facial types in a sample of Iraqi adults with skeletal and dental class II-division 1 and class III malocclusion(A cross sectional study)
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Background: The association between facial types and dental arches forms has considerable implications in orthodontic diagnosis and treatment planning. The aim was to establish the maxillary and mandibular dental arches width and length in skeletal and dental class II division 1 and class III malocclusion groups, find out the most frequent dental arch form and facial type and the association between them and to check the gender differences. Materials and Methods: Frontal and lateral facial photographs and maxillary and mandibular occlussal photographs for 90 iraqi subjects with age 18-25 years old (45 males and 45 females) divided equally into three groups, the 1st group with class II division 1malocclusion (overjet more than 3mm but less t

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