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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
Fri Dec 30 2022
Journal Name
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Military Arrangements for the Battle of Kadesh in 1274 BC During the Era of the New Kingdom
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The Battle of Kadesh is replete with many military arrangements that reflect the tremendous development of war preparations in the thirteenth century BC; where the expressive pictures the Egyptians left on some of the walls of their temples show the tremendous ability to organize and divide the forces and the great development that affected the war machine. Furthermore, the text accompanied these pictures reveal some news about that battle, which is considered one of the most important wars in the ancient world. Thus, the importance of the study lies in the fact that it examines one of the most important battles of the ancient Near East, the results of which had great repercussions on the region. This is because it is the most abundant B

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Publication Date
Sat Jun 21 2025
Journal Name
Journal Of Physical Education
Some Biomechanical Limitation During Acceleration Phase and Its Relationship With (110) m Hurdles Achievement for Advance Runners
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Publication Date
Tue Feb 18 2020
Journal Name
Modelling And Simulation In Engineering
Temperature and Stress Evaluation during Three Different Phases of Friction Stir Welding of AA 7075-T651 Alloy
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The current study performs an explicit nonlinear finite element simulation to predict temperature distribution and consequent stresses during the friction stir welding (FSW) of AA 7075-T651 alloy. The ABAQUS® finite element software was used to model and analyze the process steps that involve plunging, dwelling, and traverse stages. Techniques such as Arbitrary Lagrangian–Eulerian (ALE) formulation, adaptive meshing, and computational feature of mass scaling were utilized to simulate sequence events during the friction stir welding process. The contact between the welding tool and workpiece was modelled through applying Coulomb’s friction model with a nonlinear friction coefficient value. Also, the model considered the effect of nonlin

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Publication Date
Mon May 01 2023
Journal Name
Journal Of Engineering
Parametric Analysis of Surface Roughness and Metal Removal Rate during Electrical Discharge Machining of O1 Tool Steel
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This work studies the impact of input machining parameters of Electrical Discharge Machining (EDM) on the machining process performance. Tool steel O1 was selected as the workpiece material, copper as the electrode material, and kerosene as the dielectric medium. Experimental runs have been carried out with a Design of Experiment (DOE) technique. Twenty tests are accomplished with the current range of (18 to 24 Ampere), a pulse duration range of (150 to 200 µs), and a pulse-off time range of (25 to 75 µs). Based upon the experimental study's output results, the EDM parameter's effect (voltage of power supply, discharge current, pulse duration, and pulse pause interval) on the responses of the process represented by sur

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Publication Date
Sun Mar 29 2020
Journal Name
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Stable Dispersion of Coal Fines during Hydraulic Fracturing Flowback in Coal Seam Gas Reservoirs—An Experimental Study
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In subterranean coal seam gas (CSG) reservoirs, massive amounts of small-sized coal fines are released during the production and development stages, especially during hydraulic fracturing stimulation. These coal fines inevitably cause mechanical pump failure and permeability damage due to aggregation and subsequent pore-throat blockage. This aggregation behavior is thus of key importance in CSG production and needs to be minimized. Consequently, such coal fines dispersions need to be stabilized, which can be achieved by the formulation of improved fracturing fluids. Here, we thus systematically investigated the effectiveness of two additives (ethanol, 0.5 wt % and SDBS, 0.001 and 0.01 wt %) on dispersion stability for a wide range of condit

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Publication Date
Wed Apr 01 2020
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Plant Archives
Effect of alternate water quality irrigation on pore sizes distribution during drainage in clay loam texture soil
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Publication Date
Thu Aug 31 2017
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The Effect of Cyclic Bending Loads on Crack Growth in Pipes for Inclined and Transverse Cracks with or Without Internal Pulsing Pressure
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Publication Date
Wed Mar 01 2023
Journal Name
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Publication Date
Sun Jul 30 2023
Journal Name
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Integration of Sunflower and Sorghum Water Extracts Applied Alone or in Combination With Reduced Doses of Chevalier for Weed Control in Wheat
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      Field trial was conducted with the aim of utilizing extract of allelopathic crop to reduce the use of synthetic herbicides in wheat fields. Sorghum extract at 12 L /ha, sunflower extract at 12 L /ha, combination of sorghum and sunflower extracts at 12 L /ha and chevalier at 25, 50 and 100% of recommended dose were applied alone or in combination with each other. Weed free and weedy check treatments were included for comparison. The experiment was conducted in a randomized complete block design with three replications. The results showed that the recommended  dose of chevalier  treatment recorded lowest means of weed density 15.7, 23.7, 25.3 and 27.9 weeds m-2and weeds dry weight 13.4, 16.4, 23.3 and 29.2 g m-2 and gave

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Publication Date
Mon Sep 13 2021
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A numerical study to improve the position and angle of the producer gas injector inside the intake manifold to minimize emissions and efficiency enhancement of a bi engine
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To develop a petrol engine so that it works under the bi-engine pattern (producer gas-petrol) without any additional engine modifications, a single-point injection method inside the intake manifold is a simple and inexpensive method. Still, it leads to poor mixing performance between the air and producer gas. This deficiency can cause unsatisfactory engine performance and high exhaust emissions. In order to improve the mixing inside the intake manifold, nine separate cases were modelled to evaluate the impact of the position and angle orientation inside the intake manifold on the uniformity and spread of the mixture under AFR=2.07. A petrol engine (1.6 L), the maximum engine speed (8000 rpm), and bi-engine mode (petrol-producer ga

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