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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
Sun Jan 01 2017
Journal Name
Journal Of Research In Medical Sciences
Procalcitonin levels and other biochemical parameters in patients with or without diabetic foot complications
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Publication Date
Sat Jun 01 2019
Journal Name
Journal Of Economics And Administrative Sciences
(Dynamic& Static) Forecast of surplus or Deficit of Public budget in Iraq for (2017،2018)
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 This research aims at forecasting the public budget of Iraq (surplus or deficit) for 2017 & 2018 through using two methods to forecast. First: forecast budget surplus or deficit by using IMF estimations average oil price per barrel adopted in the public federal budget amounted to USD 44 in 2017 & USD 46 in 2018; Second: forecast budget surplus or deficit by using MOO actual average oil price in global markets amounted to USD 66 in 2018 through applying Dynamic Model & Static Model. Then analyze the models to reach the best one. The research concluded that those estimations of dynamic forecasting model of budget surplus or deficit for 2017 & 2018 gives good reliable results for future periods when using the a

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Publication Date
Tue Nov 11 2025
Journal Name
Jornal Of Al-muthanna For Agricultural Sciences
A Proposed Approach to Agricultural Extension in Iraq for a Better Response to the Needs of farmer’s to Address Their Challenges
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Publication Date
Tue Dec 31 2019
Journal Name
Journal Of Economics And Administrative Sciences
A Try to combine more than approaches and competitive strategies to achieve a sustainable competitive advantage.
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The objective of this research paper is two-fold. The first is a precise reading of the theoretical underpinnings of each of the strategic approaches: "Market approach" for (M. Porter), and the alternative resource-based approach (R B V), advocates for the idea that the two approaches are complementary. Secondly, we will discuss the possibility of combining the two competitive strategies: cost leadership and differentiation. Finally, we propose a consensual approach that we call "dual domination". 

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Publication Date
Fri Jan 01 2021
Journal Name
Aip Conference Proceedings
Preparation and characterization of mawsonite Cu6Fe2SnS8 [CFTS] thin films via the semi-computerized spray pyrolysis technique for photovoltaic applications
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Publication Date
Fri May 01 2015
Journal Name
Ibn Al-haitham J. For Pure & Appl. Sci.
Study the Effect of Irradiation on Structural and Optical Properties of (CdO) Thin Films that Prepared by Spray Pyrolysis
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In this research, the study effect of irradiation on structural and optical properties of thin film (CdO) by spray pyrolysis method, which deposited on glasses substrates at a thickness of (350±20)nm , The flow rate of solution was 5 ml/min and the substrate temperature was held constant at 400˚C.The investigation of (XRD) indicates that the (CdO) films are polycrystalline and type of cubic. The results of the measuring of each sample from grain size, micro strain, dislocation density and number of crystals the grain size decreasing after irradiation with gamma ray from(27.41, 26.29 ,23.63)nm . The absorbance and transmittance spectra have been recorded in the wavelength range (300-1100) nm in order to study the optical properties. the op

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Publication Date
Sun Mar 03 2019
Journal Name
Muthanna Journal Of Agriculture Science
EFFECT OF FOLIAR SPRAY WITH SEAWEEDS EXTRACT ON YIELD AND QUALTY FOUR CLASS OF BROAD BEAN (Vicia faba L.)
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A field experiment was carried out in one of the agricultural fields in Thi Qar governorate in Nasiriyah during the winter season 2017-2018 The aim was to investigate the effect of foliar application of seaweed extract on yield and quality of four varieties of broad bean .The design of field experiment was (RCBD) in factorial experiments with three replications in two factors. .The first factor included four broad bean cultivars (Luz de otono – Grano Violtto -local - Aquadols. ( The second factor included four sprayed extracts of the seaweed extract (1, 2, 3 and 4 g L -1) In addition to the comparison treatment in which the plants were sprayed with distilled water only. . The plants of the broad bean that were sprayed with seaweed extract

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Publication Date
Mon Mar 08 2021
Journal Name
Baghdad Science Journal
Analytical Potentiality of Computer - Controlled Background Correction with Electrothermal Atomic Emission Spectrometry : Determination of Copper in Milk Powder
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A fully automatic electrothermal atomic emission spectrometry (ETA-AES) is described. This system is based on an echelle monochromator modified for wave¬length modulation which is completely controlled by microcomputer . The advantages of the system in atomic spectrometry have been discussed . Aspects of the analytical performances such as calibration ? dection limit, precision , and recovery for copper are considered . This system is applied for routine determination of copper in commercial powdered mill? by slurr>' atomization versus aqueous atomization techniques.

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Publication Date
Tue Jan 01 2019
Journal Name
Marine And Petroleum Geology
Geophysical evidence for structurally-controlled, authigenic carbonate cementation in the Laminaria High, Bonaparte basin, Northwest Shelf of Australia
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Publication Date
Fri Mar 21 2025
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Microbes And Infectious Diseases
Microbial contamination of Lettuce (Lactuca sativa) and soil profile in Kirkuk regions under controlled application of domestic wastewater
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