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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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Sat Jan 01 2022
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Revista Iberoamericana De Psicologia Del Ejercicio Y El Deportethis Link Is Disabled.,
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Mon Apr 17 2023
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Development of a Multi-Completion Gas and Downhole Water Sink-Assisted Gravity Drainage (MC-DWS-AGD) to Improve Oil Recovery and Reduce Water Cut in Reservoirs with Strong Water Aquifers
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Abstract<p>Gas and downhole water sink assisted gravity drainage (GDWS-AGD) is a promising gas-based enhanced oil recovery (EOR) process applicable for reservoirs associated with infinite aquifers. However, it can be costly to implement because it typically involves the drilling of multiple vertical gas-injection wells. The drilling and well-completion costs can be substantially reduced by using additional completions for gas injection in the oil production wells through the annulus positioned at the top of the reservoir. Multi-completion-GDWS-AGD (MC-GDWS-AGD) can be configured to include separate completions for gas injection, oil, and water production in individual wells. This study simulates</p> ... Show More
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Fri May 01 2015
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Journal Of The Faculty Of Medicine
Gentamycin injection in disc space during lumbar discectomy (aiming to prevent post - operative discitis)
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Wed Mar 11 2020
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Applied multivariate analysis of variance in experiment of randomized design
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The general aim of an experimental design in this paper was to estimate the different treatments effects on the responses by statistical methods. The estimates must be averting biases and the random errors minimized as much as possible. We used multivariate analysis of variance (MANOVA) to analyze design of experiments for several responses. In this paper, we provided three fertilizers (mineral, humic, micro-elements) applied on Yellow Maize experiment. This experiment was conducted by completely randomized design (CRD). We tested four responses (Chlorophyll in paper, total ton / ha, paper area / cm2 and plant height / cm) together to find significant test between them. The partial correlations are between Chlorophyll in paper and total ton

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Tue Nov 30 2021
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Developing a Prosthesis Design using A Gearbox to Replicate the Human Hand Mechanism
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A New Strategy to Modify Hopfield by Using XOR Operation
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