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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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Tue Jan 01 2019
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Journal Of The College Of Languages (jcl)
To Shape a Silence While Breaking it: Toni Morrison’s the Bluest Eye
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Toni Morrison (1931-), the first African-American winner of Noble Prize in literature (1993) and the winner of the 1988 Pulitzer Prize for fiction, regards herself as the historian of African-American people. She does not think of her writings as literature but as a sacred book dedicated to explore the interior lives of blacks. She creates history by disregarding European standards and the white man's view of African- Americans. She adopts her people's point of view, invests their heritage, voices their pains and uses their vernacular. She even writes to a black audience. She establishes the black novel  by depicting the blackness of American literature. In choos

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Two-Step Catalytic Conversion of Ethanol to Butadiene in a Fixed Bed
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Wed Mar 02 2022
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Mon Jul 01 2019
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Tue Dec 30 2014
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Approaches to the formation of a contemporary explanatory mindset: Critical inductive study
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Sun Jul 09 2023
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Sat Feb 09 2019
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A comparative Study to calculate the Runs Property in the encryption systems
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