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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 Jan 01 2023
Journal Name
Biomed Research International
Efficacy of Autogenous Dentin Biomaterial on Alveolar Ridge Preservation: A Randomized Controlled Clinical Trial
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Background. After tooth extraction, alveolar bone resorption is inevitable. This clinical phenomenon challenges dental surgeons aiming to restore esthetic and function. Alveolar ridge preservation can be applied to minimize dimensional changes with a new socket grafting material, an autogenous dentin graft, produced by mechanically and chemically processing natural teeth. This study assessed the safety and efficacy of using autogenous dentin biomaterial in alveolar ridge preservation. Materials and Methods. Patients with nonrestorable maxillary anterior teeth bounded by natural sound teeth were included in this study. After a detailed clinical and tomographic examination, eligibl

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Publication Date
Wed Dec 27 2023
Journal Name
Biomed Research International
Efficacy of Autogenous Dentin Biomaterial on Alveolar Ridge Preservation: A Randomized Controlled Clinical Trial
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Background. After tooth extraction, alveolar bone resorption is inevitable. This clinical phenomenon challenges dental surgeons aiming to restore esthetic and function. Alveolar ridge preservation can be applied to minimize dimensional changes with a new socket grafting material, an autogenous dentin graft, produced by mechanically and chemically processing natural teeth. This study assessed the safety and efficacy of using autogenous dentin biomaterial in alveolar ridge preservation. Materials and Methods. Patients with nonrestorable maxillary anterior teeth bounded by natural sound teeth were included in this study. After a detailed clinical and tomographic examination, eligible participants were randomly allocated into two groups

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Publication Date
Mon Apr 21 2025
Journal Name
Structural Concrete
On the effectiveness of shear reinforcement type in <scp>GFRP</scp>‐reinforced concrete beams: Experimental study
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Abstract<p>This study investigated the shear performance of concrete beams with GFRP stirrups vs. traditional steel stirrups. Longitudinal glass fiber‐reinforced polymer (GFRP) bars were used to doubly reinforce the tested beams at both the top and bottom of their cross sections. To accomplish this, several stirrup spacings were provided. Eight beam specimens, measuring 300 × 250 × 2400 mm, were used in an experimental program to test under a two‐point concentrated load with an equal span‐to‐depth ratio until failure. Four beams in Group I have standard mild steel stirrups of 8 mm diameter, while four beams in Group II have GFRP stirrups with the same adopted diameter. The difference betwe</p> ... Show More
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Publication Date
Mon Apr 21 2025
Journal Name
Structural Concrete
On the effectiveness of shear reinforcement type in <scp>GFRP</scp>‐reinforced concrete beams: Experimental study
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Abstract<p>This study investigated the shear performance of concrete beams with GFRP stirrups vs. traditional steel stirrups. Longitudinal glass fiber‐reinforced polymer (GFRP) bars were used to doubly reinforce the tested beams at both the top and bottom of their cross sections. To accomplish this, several stirrup spacings were provided. Eight beam specimens, measuring 300 × 250 × 2400 mm, were used in an experimental program to test under a two‐point concentrated load with an equal span‐to‐depth ratio until failure. Four beams in Group I have standard mild steel stirrups of 8 mm diameter, while four beams in Group II have GFRP stirrups with the same adopted diameter. The difference betwe</p> ... Show More
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Publication Date
Mon Jul 28 2025
Journal Name
Structural Concrete
Behavior of axially loaded concrete composite columns encased with <scp>GFRP</scp> and steel I‐sections
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Abstract<p>The aim of this investigation is to evaluate the experimental and numerical effectiveness of a new kind of composite column by using Glass Fiber‐Reinforced Polymer (GFRP) I‐section as well as steel I‐section in comparison to the typical reinforced concrete one. The experimental part included testing six composite columns categorized into two groups according to the slenderness ratio and tested under concentric axial load. Each group contains three specimens with the same dimensions and length, while different cross‐section configurations were used. Columns with reinforced concrete cross‐section (reference column), encased GFRP I‐section, and encased steel I‐section were adopted in each </p> ... Show More
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Publication Date
Wed Nov 23 2022
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Dental Hypotheses
Remineralization of Dentine Caries Using Moringa Oleifera Based Nano-Silver Fluoride: A Single-Blinded, Randomized, Active-Controlled Clinical Trial
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Publication Date
Tue Aug 25 2020
Journal Name
Journal Of Clinical Medicine
Self-Limiting versus Rotary Subjective Carious Tissue Removal: A Randomized Controlled Clinical Trial—2-Year Results
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Background: the aim of this study was to assess the 2-year pulp survival of deep carious lesions in teeth excavated using a self-limiting protocol in a single-blind randomized controlled clinical trial. Methods: At baseline, 101 teeth with deep carious lesions in 86 patients were excavated randomly using self-limiting or control protocols. Standardized clinical examination and periapical radiographs of teeth were performed after 1- and 2-year follow-ups (REC 14/LO/0880). Results: During the 2-year period of the study, 24 teeth failed (16 and 8 at T12 and T24, respectively). Final analysis shows that 39/63 (61.9%) of teeth were deemed successful (16/33 (48.4%) and 23/30 (76.6%) in the control and experimental groups, respectively wit

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Publication Date
Tue Aug 15 2023
Journal Name
Bionatura
The role of ferric citrate in a sample of Iraqi patients on hemodialysis- A randomized controlled clinical trial
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Background: Uncontrolled hyperphosphatemia is the main difficulty facing staff treating patients with end-stage renal disease on hemodialysis. Sevelamer and calcium-containing phosphate binders have been associated with cost burden and tissue calcification, respectively. Therefore, the current trial was targeted to investigate the efficacy of a new phosphate binder, ferric citrate, in a sample of Iraqi patients with end-stage renal disease on hemodialysis. Keywords: Ferric citrate, Hemodialysis Phosphate binder

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Publication Date
Wed Jun 15 2022
Journal Name
Journal Of Baghdad College Of Dentistry
Effects of various analgesics on pain perception and rate of tooth movement: a randomized controlled clinical study
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Background: Pain is one of the most reported side effects of orthodontic treatment despite the advanced technology in orthodontics. Many analgesics have been introduced to control orthodontic pain including acetaminophen and selective and nonselective nonsteroidal anti-inflammatory drugs. The great concern about these drugs is their adverse effect on rate of teeth movement. Aims: The purpose of this study was to evaluate and compare the effect of acetaminophen, ibuprofen and etoricoxib on pain perception and their influence on the rate of teeth movement during leveling and alignment stage. Methods: Forty patients were evenly and randomly distributed in a blinded way to one of four groups: placebo (starch capsules), acetaminophen 500mg th

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Publication Date
Sun Jun 30 2013
Journal Name
Al-kindy College Medical Journal
The Combination Effect of Lidocaine, Ketamine and Atracurium in Intravenous Regional Anesthesia
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Background: intravenous regional anaesthesia (IVRA) is an effective method of producing anaesthesia of the extremities. Disadvantages are the rapid loss of anaesthesia after the deflation of the tourniquet and the rapid development of postoperative pain. It is important to search for agents with longer durations of action, better nerve fibre selectivity, lesser degrees of motor blockade and lower incidences of systemic toxicity.Objectives: This study was designed to evaluate and compare the clinical effects of intravenous regional anaesthesia, with lidocaine alone, or in a combination with ketamine and atracurium for better analgesia, and to examine the possible clinical advantages of using muscle relaxants (i.e., atracurium) with intrav

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