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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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Wed Aug 27 2025
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Sun Jul 01 2018
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Emotional Innovation and Its Relation to Foresight, Meditation, and Constructive Thinking among University Students
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The study aims to examine the emotional innovation, constructive thinking, foresight, and meditation among university students. Besides, attempts to explore the relationship between emotional innovation and constructive thinking, the relationship between emotional innovation and foresight, and meditation, the relationship between constructive thinking and foresight, and meditation, finally, the relationship among emotional innovation, constructive thinking, foresight, and meditation of university students regarding the variables of gender and major. A total of (400) students were selected as a sample for the study. The results revealed that university students have a high level of emotional innovation that induce them to take positive ro

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Wed Nov 21 2018
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Al–bahith Al–a'alami
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Sat Nov 10 2018
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Iraqi National Journal Of Nursing Specialties
Effect of Long Term Exposure to Sodium Nitrite on Gene Responsible for DNA Repair
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Objective: The aim of this study is to detect the effect of continuous exposure to Sodium Nitrite on 8-oxoguanine
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Sun Jan 01 2017
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Publication Date
Wed Jan 30 2019
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The exact location and its relation to cognitive method (risk-caution) of University students
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The present study aimed to identify the exact location and its relation to cognitive
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Sat May 11 2013
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Association of HLA-DRB1/DQB1 Alleles and Genetic Susceptibility to Type 1 Diabetes Mellitus
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