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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
Wed Mar 10 2021
Journal Name
Baghdad Science Journal
An Approximate solution for two points oundary value problem corresponding to some optimal control
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this paper presents a novel method for solving nonlinear optimal conrol problems of regular type via its equivalent two points boundary value problems using the non-classical

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Publication Date
Wed Apr 03 2013
Journal Name
Iraqi Journal Of Medical Sciences
Ligasure versus clamp and tie technique to achieve henostasis in thyroidectomy for benign diseases
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Publication Date
Sun Jun 30 2024
Journal Name
Journal Of The College Of Education For Women
From Mourning to Empowerment: The Representation of Widow in Selected English and Arabic Poems
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فقدان الزوج يعد حدثًا يغير حياة النساء، مما يضطرهن إلى السباحة في عالم جديد مليء بالحزن والوحدة والشكوك. مع الوقت، تطورت طريقة تصوير الأرامل بشكل كبير تعكس التغييرات في الآراء والقيم الثقافية. تُمثل الأرامل تقليديًا بأنهن ضعيفات ومعتمدات في الأدب، مستندة إلى افتراض أنهن يفتقدن الدعم المالي بعد وفاة شركائهن. ومع ذلك، فإن هذا التصوير لا يعترف بتأثير الأرملة على الرفاهية والهوية الشخصية. يسعى هذا النص إلى

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Publication Date
Tue Oct 30 2018
Journal Name
Journal Of Engineering
Statistical Equations to Estimate the In-situ Concrete Compressive Strength from Non-destructive Tests
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The aim of this study is to propose reliable equations to estimate the in-situ concrete compressive strength from the non-destructive test. Three equations were proposed: the first equation considers the number of rebound hummer only, the second equation consider the ultrasonic pulse velocity only, and the third equation combines the number of rebound hummer and the ultrasonic pulse velocity. The proposed equations were derived from non-linear regression analysis and they were calibrated with the test results of 372 concrete specimens compiled from the literature. The performance of the proposed equations was tested by comparing their strength estimations with those of related existing equations from literature. Comparis

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Publication Date
Sat Jan 01 2022
Journal Name
Geotechnical Engineering And Sustainable Construction
Towards Sustainable Local Tourism to Conserve the Natural Environment: Foundations of Sustainable Ecolodge Design
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Publication Date
Tue Mar 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
Comparative Study for the Early Detection of the most Important Factors Leading to Preeclampsia
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The aim of this research is to determine the most important and main factors that lead to Preeclampsia. It is also about finding suitable solutions to eradicate these factors and avoid them in order to prevent getting Preeclampsia. To achieve this, a case study sample of (40) patients from Medical City - Oncology Teaching Hospital was used to collect data by a questionnaire which contained (17) reasons to be investigated. The statistical package (SPSS) was used to compare the results of the data analysis through two methods (Radial Bases Function Network) and (Factorial Analysis). Important results were obtained, the two methods determined the same factors that could represent the direct reason which causes Preecla

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Publication Date
Sat Oct 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Evaluating Training Programs According to model Kirkpatrick / field research in the Health Maysan Directorate .
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This present paper aim at knowing  the process of evaluating the training program that could be applied  in Maysan Health office  for it significance and importance in field of management and vocational staff  preparations  of high  scientific experience in different fields of  Health.  The society of research includes staffs  working in Maysan Health Office  , of specialists ,  dentists, pharmacists, laboratories, nursing  and administrators. Their number is 100 employees, the researcher has designed questionnaire by depending on "Kirkpatrick"  for assessing  the training . The researcher has used   thorough survey and has entailed 90 questionnaire,

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Publication Date
Mon Nov 01 2021
Journal Name
2021 International Conference On Intelligent Technology, System And Service For Internet Of Everything (itss-ioe)
Application of MQ-Sensors to Indoor Air Quality Monitoring in Lab based on IoT
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Publication Date
Sat Jul 01 2023
Journal Name
Journal Of Engineering
Silica Fume Modified Cement-Based Mortar Exposed to High Temperatures: Residual Strengths and Microstructure
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Several previous investigations and studies utilized silica fume (SF) or (micro silica) particles as supplementary cementitious material added as a substitute to cement-based mortars and their effect on the overall properties, especially on physical properties, strength properties, and mechanical properties. This study investigated the impact of the inclusion of silica fume (SF) particles on the residual compressive strengths and microstructure properties of cement-based mortars exposed to severe conditions of elevated temperatures. The prepared specimens were tested and subjected to 25, 250, 450, 600, and 900 °C. Their residual compressive strengths and microstructure were evaluated and compared with control samples (C

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Publication Date
Thu Jul 03 2025
Journal Name
Circular Economy And Sustainability
Green Supplier Selection in the Iraqi Food Industry: Criteria Analysis and Barriers to Implementation
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This study explores the barriers to adopting green environmental criteria in Supplier Selection (SS) within the Iraqi food industry. It aims to enhance the understanding of sustainable supply chain management in developing nations, with a particular focus on the Iraqi context. A case study approach was utilized to identify eleven key green environmental criteria and 54 sub-criteria, alongside seven major barriers to their adoption. The Best–Worst Method (BWM) was employed to rank the criteria, and Fuzzy Stepwise Weight Assessment Ratio Analysis (SWARA) was used to prioritize the barriers. The analysis revealed that Environmental Management Systems are the most critical criterion for SS. On the other hand, legislation and policies emerged

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