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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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Tue Dec 01 2015
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Developing Human Capital according to the Communities of Practice: A comparative study by using Data Envelopment Analysis
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Publication Date
Sat Nov 01 2025
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Improvement of Hot Mix Asphalt Resistance to Permanent Deformation at High Temperature Using Nanomaterial Modifiers: A Review
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Mon Apr 01 2013
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The Therapeutic Role of Isotretinoin in the Management of Behçet&#039;s Disease: A Single-Blinded, Controlled Therapeutic Study - JDDonline - Journal of Drugs in Dermatology
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Sat Dec 24 2022
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Therapeutic Effects of Vitamin E in Non-alcoholic Fatty Liver Disease: An Open-Labeled Clinical Trial
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Publication Date
Thu Sep 15 2022
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Impact of dome projection on operative steps during clipping of a ruptured pure posteriorly directed posterior communicating artery aneurysms
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Publication Date
Sun Jul 17 2022
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Publication Date
Tue Sep 01 2009
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Experimental Investigation of Reinforced Concrete Flexural Beams Strengthened or Repaired with CFRP
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Thu Oct 29 2020
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Publication Date
Sat Jun 01 2013
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Comparsion of the physical properties for CdS and CdS doped PVA thin films prepared by spray pyrolysis
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Publication Date
Sun Mar 05 2017
Journal Name
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Preparation and study of the structural and optical properties of Bi2S3 thin films by Spray pyrolysis method
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