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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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This article investigates the relationship between foot angle and jump stability, focusing on minimizing injury risk. Here are the key points: Importance: Understanding foot angle is crucial for improving jump stability, athletic performance, and reducing jump-related injuries like ankle sprains. Ideal Foot Angle: Research suggests a forward foot angle of around 15 degrees might be ideal for many people during jumps. This angle distributes forces evenly across the foot, lowers the center of gravity, and provides more surface area for pushing off the ground. Factors Affecting Ideal Angle: The optimal angle can vary depending on the type of jump (vertical vs. long jump), fitness level, and personal preference. Incorrect Foot Angles: Landing w

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Publication Date
Thu Sep 15 2022
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Thu Jul 30 2009
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Sun Sep 11 2022
Journal Name
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Non-Productive Time Reduction during Oil Wells Drilling Operations
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Tue Aug 14 2018
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The Role of the Deubiquitylase MYSM1 During Alphavirus Infection
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Publication Date
Fri Nov 29 2019
Journal Name
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Behavior of Earth Magnetosphere Radius during Strong Geomagnetic Storms
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Sat Jan 01 2022
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Fri Sep 15 2023
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Fri Mar 01 2013
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Design and Implementation of a Generalized N-Digit Binary-To-Decimal Converter on an FPGA Seven-Segment Display Using Verilog Hdl Design and Implementation of a Generalized N-Digit Binary-To-Decimal Converter on an FPGA Seven-Segment Display Using Verilog Hdl
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Fri Dec 15 2023
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The Reliability of Two Different Laser Wavelengths in Inducing Bone Healing Around Dental Implants: Comparative Clinical Trial
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