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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 30 2022
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Publication Date
Thu Oct 26 2017
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ON CONVEX FUNCTIONS, $E$-CONVEX FUNCTIONS AND THEIR GENERALIZATIONS: APPLICATIONS TO NON-LINEAR OPTIMIZATION PROBLEMS
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Fri Sep 30 2022
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Procedures for auditing accounting violations according to international auditing : standards in the Karbala Municipality Directorate
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Publication Date
Sat Jan 10 2015
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The Use of Cubic Bezier Interpolation, Biorthogonal Wavelet and Quadtree Coding to Compress Color Images
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In this paper, an efficient method for compressing color image is presented. It allows progressive transmission and zooming of the image without need to extra storage. The proposed method is going to be accomplished using cubic Bezier surface (CBI) representation on wide area of images in order to prune the image component that shows large scale variation. Then, the produced cubic Bezier surface is subtracted from the image signal to get the residue component. Then, bi-orthogonal wavelet transform is applied to decompose the residue component. Both scalar quantization and quad tree coding steps are applied on the produced wavelet sub bands. Finally, adaptive shift coding is applied to handle the remaining statistical redundancy and attain e

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Tue Jan 01 2013
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Sorption Mechanism and Capacity Evaluation of Palygorskite from Iraq to Remove Pb from Aqueous Solution
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Publication Date
Sat Sep 13 2025
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An Antimicrobial Activity of Moringa Oleifera Extract in Comparison to Chlorhexidene Gluconate (In vitro study)
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Background: Oral diseases persist to be a major health problem all over the world. Various bacteria and fungi are found to be the possible pathogensresponsible for the oral diseases. Moringa oleifera it is an extraordinary nutritious vegetable tree with many different uses. These leaves have high medicinal value. In the present study, antibacterial and antifungal activities of aqueous extracts of plant Moringa oleifera in comparison to chlorohexidene gluconate and deionized water were determined. Materials and methods: The leaves of plant of Moringa oleifera were collected from College of Pharmacy; Baghdad, Iraq. Tested microorganism (bacterial and fungal) was isolated from different clinical specimens. In-vitroantimicrobial activity was pe

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Fri Oct 01 2021
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In this study, the effect of fire flame on the punching shear strength of steel fiber reinforced concrete flat plates was experimentally investigated using nine half-scale specimens with dimensions of 1500×1500 mm and a total thickness of 100 mm. The main investigated variables comprised the steel fiber volume fraction 0, 1, and 1.5% and the burning steady state temperature 500 and 600 °C. The specimens were divided into three groups, each group consists of three specimens. The specimens in the first group were tested with no fire effect to be the reference specimens, while the others of the second and third groups were tested after being exposed to fire-flame effect. The adopted characteristics of the fire test were; (one hour) b

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Publication Date
Sun Apr 01 2018
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