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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
Fri Mar 15 2019
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The Warning Messages of Jeanne DuPrau’sThe City of Ember to the World with Reference to Gil Kenan’s Film Adaptation: The Theory of Conspiracy
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The City of Ember is a very interesting novel that is although intended for young readers, have so many layers and messages that are misunderstood. In this research, both the novel and the film adaptation are studied with the intent to decode the warning messages that the novelist and the director tried to introduce to the audience. The research studies four vital messages; the first message is that history repeats itself for the novel has many allusions to the history of Jews and their painful holocaust and even goes back in history the days of Moses and the Exodus, the second message tackles the conspiracy theory that states nothing happens by accident and that everything is planned and connected hence comes the third message

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Publication Date
Sun Oct 01 2017
Journal Name
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The role of organizational change in easing the organizational conflict: an exploratory study of the opinions of a sample of managers and workers in Iraq to EarthLink Network Services Company And communications
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Publication Date
Wed Jun 01 2022
Journal Name
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A study of the level of skill self-esteem and some aspects of attention (acute - focus - diversion) and their relationship to the performance of the spiking and serve among young tennis players
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Publication Date
Sat Dec 01 2018
Journal Name
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Comparison of the method of partial least squares and the algorithm of singular values decomposion to estimate the parameters of the logistic regression model in the case of the problem of linear multiplicity by using the simulation
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Publication Date
Sun Dec 01 2019
Journal Name
Journal Of Accounting And Financial Studies ( Jafs )
Measuring the impact of internal control on tax performance using balanced score card indicators: An applied research in a sample of the branches of the General Tax Authority in Iraq
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Publication Date
Wed Dec 25 2019
Journal Name
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Desalination by Membrane Distillation Using Electrospun Membranes
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Publication Date
Tue Sep 01 2009
Journal Name
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Colorimetric assay of aspirin using modified method
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Sat Mar 30 2013
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Sun Jun 07 2015
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Steganography in Audio Using Wavelet and DES
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