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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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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.

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Thu Jul 01 2021
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Forecasting enhancement using a hodrick-prescott filter
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Publication Date
Wed Aug 07 2019
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Effect of Non-Pharmacological Pain Management Methods on Reduction the Duration of Labor Stages in Primigravida Women at AL-Elwyia Maternity Teaching Hospital
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Publication Date
Sat Jun 25 2022
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Microneedles as A Magical Technology to facilitate Transdermal Drug Delivery: A Review Article
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Thu Mar 02 2023
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Wed Sep 28 2022
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