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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
Tue Dec 30 2008
Journal Name
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Myomectomy During Early Pregnancy
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Myoma is a common benign uterine tumor; therefore
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have complications related to myoma in pregnancy.
Few treatment options are available during pregnancy,
conservative treatment with analgesia, reassurance and
supportive therapy is almost always adequate but in
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uterine myoma and obstructed labor, surgical
intervention during pregnancy is occasionally
necessary in uncommon cases of intractable pain.
19 years old lady presented with intractable lower
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Publication Date
Wed Jan 30 2013
Journal Name
Al-kindy College Medical Journal
Regeneration of Pain, Touch, Cold, and Warmth, sensations in split thickness human skin grafts in adults (A clinical study)
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Back ground: Skin grafting is the most common form
of reconstructive surgery, and regeneration of
sensations in skin grafts is a complex process
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the graft, the depth of the grafted bed, meshing of the
graft, the condition of the bed and the surrounding
area. So many studies performed on this subject, some
of them clinically based on subjective type of sensation
tests, and others histological to detect the presence of
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thickness skin grafts by clinical methods.
Methods: From Oct. 1995 to Oct. 2010, a clinical
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Publication Date
Thu Oct 01 2026
Journal Name
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Work-Related Musculoskeletal Pain and Analgesic Use Among Undergraduate Dental Students in Iraq: A Multi-Institutional Cross-Sectional Study
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Purpose: This study aimed to evaluate the prevalence of work-related musculoskeletal pain (WMSP), analgesic use practices, pharmacological knowledge, attitudes toward unsupervised analgesic use, and ergonomic/non-pharmacological behaviors in this cohort. Patients and Methods: An online questionnaire was sent to third- to fifth-year Iraqi dental students using WhatsApp, Facebook, and Telegram platforms. The link was shared three times weekly during March–May 2026. The survey collected sociodemographic data, musculoskeletal pain experience, analgesic use patterns (especially non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol), pharmacological knowledge, attitudes toward unsupervised analgesic use, and ergonomic/non-pharmacologic

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Publication Date
Fri Jul 27 2012
Journal Name
Journal Of Prosthodontics
A Three-Dimensional Finite Element Analysis for Overdenture Attachments Supported by Teeth and/or Mini Dental Implants
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Publication Date
Sat Dec 28 2024
Journal Name
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The effect of using special intense exercise accompanied by intermittent electrical stimulation to get rid of lower neck pain among professors of the College of Science - University of Baghdad for ages (40-60) years
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Lower neck pain is one of the problems facing all ages, especially the elderly, as it revolves around the causes of this pain from many diverse factors. The aim of the research is to use special intense exercise accompanied by intermittent electrical stimulation to get rid of lower neck pain among professors of the College of Science - University of Baghdad for ages. (40-60) years and to identify the extent of the effect. The research assumed the presence of statistically significant differences. The research sample represented professors at the University of Baghdad - College of Science who suffer from continuous pain for the period between (10/15/2023) and (1/15/) 2024) and their number is (5), The researchers used the experimenta

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Publication Date
Thu Oct 16 2025
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Design and evaluation of a mucoadhesive gel-forming spray for local delivery of betamethasone sodium phosphate in aphthous ulcer management
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Mouth ulcers are common oral lesions. Although several topical treatments are commercially available, their limited residence time requires frequent application, which remains a significant drawback. This study aimed to develop a novel mucoadhesive, thermosensitive, in situ gel-forming spray for local delivery of betamethasone sodium phosphate, thereby reducing systemic exposure. Formulations were optimized using the design of experiment approach to investigate the effects of thermosensitive polymers (Poloxamer 407 and Poloxamer 188), mucoadhesive polymer (hyaluronic acid), and drug incorporation on gelation temperature and time. The optimized formulation gelled at 33.3 ± 0.7 °C within 14.79 ± 1.87 s and showed a spray angle of 4

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Wed Mar 29 2023
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Language ecology is the interactions between the environment and language. Such a discipline, ‘language ecology’ or ‘ecolinguistics has been founded by Einar Haugen’. Accordingly,  the study aims at qualitatively reviewing the theoretical and conceptual issues surrounding the subject of language ecology  by tracing the roots of language ecology. It further highlights the fundamental inconsistencies between how the concept of ecology is perceived in sociology and biology, and is applied to language, particularly, transposing the main central concepts of bio-ecology, such as relationship/interaction, environment, and organism to human language and theory of ecological-linguistic. The theory wavers among placing the focus

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Tue Apr 30 2019
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International Journal Of Environmental Research
A Comparative Study for the Identification of Superior Biomass Facilitating Biosorption of Copper and Lead Ions: A Single Alga or a Mixture of Algae
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