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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
Sat Jul 19 2025
Journal Name
Journal Of Pharmacology And Pharmacotherapeutics
Pharmaceutical Frontliners: Community Pharmacists’ Contribution to Managing Medication Needs During a Health Crisis— The COVID-19 Era as an Example
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Community pharmacists faced more complex challenges in meeting patients’ medication needs during the pandemic than previously reported in the literature. Objectives To explore the perception and abilities of community pharmacists in managing patients’ needs in terms of medication dispensing during the pandemic, and to examine its effect on improving the patients’ situations. Materials and Methods A cross-sectional study design, validated by 30 experts, was conducted using an electronic survey (Google Form) to assess the effect of the dispensing practice of Iraqi community pharmacists on the patient’s clinical outcomes during the pandemic. The survey was distributed on professional pharmacist’s social media platforms from December

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Sat Jun 01 2013
Journal Name
Journal Of Economics And Administrative Sciences
The nature of financial system Is it an necessity or A selection?
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   The Financial systems can be classified into two types. The first is the market–oriented, which is applied in United States and United Kingdom. While the second is bank-oriented as in Japan and Germany.

   This study tries to explain the reasons which make some countries adopt the first one instead of the second, and the contrary. So the study consists of three sections. The first deals with the concept of financial system and it are functions. The second displays the indicators which are used to classify the financial systems, while the third one is devoted to the factors that determine the type of financial system .These sections followed by some conclusions.

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Publication Date
Sun Jan 01 2023
Journal Name
Ssrn Electronic Journal
Design of Earthquake-Resistant Buildings by Using Reinforced Concrete or Steel Flexible Corner Joints
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This study focuses on studying the effect of reinforced steel in detail, and steel reinforcement (tensile ratio, compression ratio, size, and joint angle shape) on the strength of reinforced concrete (compressive strength) Fc' and searching for the most accurate details of concrete divisions, their behavior, and corner resistance of reinforced concrete joint. The comparison of this paper with previous studies, especially in the studied properties. The conclusions of the chapter are summarized that these effects had a clear effect and a specific effect on the behavior and resistance of the reinforced concrete corner joints under the negative moments and under their influence and the resulting stress conditions. The types of defects that can

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Wed May 10 2023
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Lactic acid-based deep eutectic solvents and activated carbon for soap removal from crude biodiesel
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Publication Date
Fri Oct 23 2020
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Medico-legal Update
Role of Endoscopic Ultrasound Guided Fine Needle Aspirate for Evaluating Lesions in or Adjacent to Gastrointestinal Tract: A Single Tertiary Care Center Experience
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Wed Aug 31 2022
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Xenotransplantation: Fact or Magic
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The knowledge of transferring body organs or tissues appears in the ancient mythology of Roman, Greek, Indian, Chinese, and Egyptian civilizations. The stories of organ transplants performed by GODs and health care’s using organs from cadaveric and after that transplantation change from lore to medical training

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Publication Date
Wed Dec 22 2021
Journal Name
Polymers
Modifications of Polymers through the Addition of Ultraviolet Absorbers to Reduce the Aging Effect of Accelerated and Natural Irradiation
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The photooxidative degradation process of plastics caused by ultraviolet irradiation leads to bond breaking, crosslinking, the elimination of volatiles, formation of free radicals, and decreases in weight and molecular weight. Photodegradation deteriorates both the mechanical and physical properties of plastics and affects their predicted life use, in particular for applications in harsh environments. Plastics have many benefits, while on the other hand, they have numerous disadvantages, such as photodegradation and photooxidation in harsh environments and the release of toxic substances due to the leaching of some components, which have a negative effect on living organisms. Therefore, attention is paid to the design and use of saf

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Publication Date
Wed Dec 30 2009
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Iraqi Journal Of Chemical And Petroleum Engineering
Mass Transfer Correlations for a Rotating Cylinder Electrode under lsothermal and Controlled Heat Transfer Condition
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Mass transfer correlations for iron rotating cylinder electrode in chloride/sulphate solution, under isothermal and
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potentiostatic experiments at different bulk temperatures and various turbulent flow rates, under isothermal and heat
transfer conditions, were used for such derivation. The corelations were analogous to that obtained by Eisenberg et all
and other workers.

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Publication Date
Fri Jan 01 2016
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Implementation And Evaluation Of Apm 2.6 - Controlled Quadcopter With Aerial Imagery As A Case Study
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Wed Mar 01 2023
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Baghdad Science Journal
Pharmacokinetic Consideration to Formulate Sustained Release Drugs: Understanding the Controlled Drug Diffusion through the Body Compartment of the Systemic Circulation and Tissue Medium-A Caputo Model
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The aim of this study is to provide an overview of various models to study drug diffusion for a sustained period into and within the human body. Emphasized the mathematical compartment models using fractional derivative (Caputo model) approach to investigate the change in sustained drug concentration in different compartments of the human body system through the oral route or the intravenous route. Law of mass action, first-order kinetics, and Fick's perfusion principle were used to develop mathematical compartment models representing sustained drug diffusion throughout the human body. To adequately predict the sustained drug diffusion into various compartments of the human body, consider fractional derivative (Caputo model) to investiga

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