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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
Mon Sep 15 2025
Journal Name
Journal Of Administration And Economics
Using the Maximum Likelihood Method with a Suggested Weight to Estimate the Effect of Some Pollutants on the Tigris River- City of Kut
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The aim of this research is to use robust technique by trimming, as the analysis of maximum likelihood (ML) often fails in the case of outliers in the studied phenomenon. Where the (MLE) will lose its advantages because of the bad influence caused by the Outliers. In order to address this problem, new statistical methods have been developed so as not to be affected by the outliers. These methods have robustness or resistance. Therefore, maximum trimmed likelihood: (MTL) is a good alternative to achieve more results. Acceptability and analogies, but weights can be used to increase the efficiency of the resulting capacities and to increase the strength of the estimate using the maximum weighted trimmed likelihood (MWTL). In order to perform t

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Publication Date
Sat Jul 20 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Gender Distribution of Coronary Artery Calcium Score and Degree of Stenosis Assessed by Computed Tomography Angiography in Iraqi Patients with Chest Pain
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Background: Sex variations in coronary artery disease (CAD) are well documented. However, sex differences in coronary artery calcium (CAC) and its role in the detection of coronary artery stenosis remain controversial. Objective: To assess the impact of sex variation on coronary artery calcification and its efficacy in predicting coronary artery stenosis. Methods: This is a cross-sectional observational study including 230 consecutive patients with suspected CAD (120 men and 110 women) referred for coronary computed tomography angiography (CCTA). The study analyzed sex-based differences in the sensitivity and specificity of coronary artery calcification (CAC) for detecting moderate to severe stenosis across various coronary arteries

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Publication Date
Mon Mar 03 2014
Journal Name
Journal Of Baghdad College Of Dentistry
Stem Cells a Novel Approach to Periodontal Regeneration: A Review of Literature
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Sat Jun 01 2013
Journal Name
Journal Of The College Of Languages
Dylan Thomas:The vision of Death as a Prologue to a New Life
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Dylan Thomas (1914-1953) is a modern poet belongs to the apocalyptic movement of the 1940's.This movement is influenced by the doctrines and techniques of surrealism. Poetry for him should not be primarily concerned with man in society, but with the celebration of spiritual truth. It should bring to light the hidden causes, hence his personal interest is to strip darkness and explore the inward motives. To do this he uses a cluster of images: a constant building up and breaking down of images. His poetry depends on the romantic spontaneity, suggestiveness of the Symbolists and the the surrealists' mysterious liberation of the unconsciousness and the emotional involvement in the dynamics of life. In "Light Breaks

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Publication Date
Mon Sep 15 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Stem cells a novel approach to periodontal regeneration (A review of literature)
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In this review of literature, the light will be concentrated on the role of stem cells as an approach in periodontal regeneration.

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Publication Date
Sat Jun 01 2013
Journal Name
Journal Of The College Of Languages (jcl)
Dylan Thomas:The Vision of Death as a Prologue to a New Life
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Dylan Thomas (1914-1953) is a modern poet belongs to the apocalyptic movement of the 1940's.This movement is influenced by the doctrines and techniques of surrealism.

              Poetry for him should not be primarily concerned with man in society, but with the celebration of spiritual truth. It should bring to light the hidden causes, hence  his personal interest is to strip darkness and explore the inward motives. To do this he uses a cluster of images: a constant building up and breaking down of images. His poetry depends on the romantic spontaneity, suggestiveness of the Symbolists and the the surrealists' mysterious liberation of the unconsciousness and

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Publication Date
Thu Jan 01 2015
Journal Name
Journal Of Traumatic Stress Disorders &amp; Treatment
Randomised Controlled Study Comparing Two Psychological Therapies for Posttraumatic Stress Disorder (PTSD): Emotional Freedom Techniques (EFT) vs. Narrative Exposure Therapy (NET)
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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
A comparative study of the role of monetary policies in achieving economic growth in some oil and non-oil countries during the period 1990-2017
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The research problem was to identify the impact of monetary policies on economic growth in the oil and non-oil countries. The researcher chose the Republic of Iraq as an example for the oil countries and the Arab Republic of Egypt as an example for the non-oil countries to hold a comparison on the impact of monetary policies.

The research found that the monetary policies and their tools in the Iraqi economy affect the rate of GDP growth by 73%, which shows the strong impact of monetary policies on the economic growth in the Iraqi economy as an example of an oil state. GDP growth rate of 61%, indicating the impact of monetary policies on economic growth in the

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Publication Date
Wed Sep 28 2022
Journal Name
Journal Of The College Of Education For Women
The Male/Female Students’ Attitudes in the University College to Applied Sciences in Gaza Towards Learning Arabic Grammar Remotely in the Course of Arabic Language Requirement During Corona Pandemic
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This study deals with examining UCAS students’ attitudes in Gaza towards learning Arabic grammar online during the Corona pandemic. The researcher has adopted a descriptive approach and used a questionnaire as a tool for data collection. The results of the study have statistically shown significant differences at the level of "0.01" between the average scores of students in favor of the students of the humanities specializations. It has also been found that the students’ attitudes at the Department of Humanities and Media towards learning Arabic grammar online are positive. Additionally, the results revealed no statistical significant differences due to the variable of UCAS students’ scientific qualifications. The results stressed

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Publication Date
Wed Jan 10 2018
Journal Name
Iraqi Journal Of Market Research And Consumer Protection
ENCAPSULATION OF OMEGA-3 FATTY ACID USING NANOTECHNOLOGY TO IMPROVE ITS THERMAL STABILITY AND USE IT TO ENRICHING THE YOGURT: ENCAPSULATION OF OMEGA-3 FATTY ACID USING NANOTECHNOLOGY TO IMPROVE ITS THERMAL STABILITY AND USE IT TO ENRICHING THE YOGURT
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Concentrations 25, 50 and 100 mg of nano-capsules linolenic acid and non-capsulated fatty acid for 1kg of Milk was used for yogurt manufacture. The results showed no significant differences in the ratio of titration acidity and pH values between all processed treatments at the beginning and during of period storage. The treatments was added to it coated omega-3 by nano method were the least exposed to the oxidation process from the non-capsules omega-3, And for shield of The poly lactic acid had a significant role in the protection of alpha-linolenic acid against lipolysis by the formation of a protective layer to protect the acid from the activity of lipases enzymes, and the addition of fatty acid linolenic to milk was determined the gr

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