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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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Wed Nov 01 2023
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The G allele of the ADAM33 T1 polymorphism (rs2280091) is a risk factor associated with asthma severity among the Iraqi Arab population
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Thu Mar 15 2018
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Journal Of Baghdad College Of Dentistry
The Surface Hardness Measurement of Stone and Improved Die Stone After the Addition of a Mixture of Chemical Additives with Different Proportion
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Background: Periodontal diseases are inflammatory diseases affecting the supporting tissues of the teeth. One of the leading environmental factors that are closely related not only to the risk but also to the prognosis of periodontitis is smoking. This study aimed to evaluate the influence of smoking on periodontal health status and to measure the levels of matrix metalloproteinase-9 in smokers and nonsmokers chronic periodontitis patients, also it aimed to test the correlation between the levels of matrix metalloproteinase-9 and the clinical periodontal parameters. Materials and Methods: Five milliliters samples of un-stimulated whole saliva and full-mouth clinical periodontal recordings (plaque index, gingival index, bleeding on probing,

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Balancing Heritage Preservation and Sustainable Development in Historic Cities: A Case Study of Old Najaf in the Context of Global Best Practices
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Sat Jun 06 2026
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The Effect of Using Exercises Associated With Ischemia and Hyperemia on Some Immunoglobulins (Igm - Igg) and White Blood Cells (Wbc) in the Rehabilitation and Treatment of Ankle Sprain Injury Lateral Side of Swimmers
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Publication Date
Mon Feb 25 2019
Journal Name
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Planning and implementation of the audit process by using the styles of time management and its impact on the quality of the audit process: Applied Research in the Federal Board of Supreme Audit
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Witnessing the global arena many changes in the political, economic, social, scientific and technological have left their mark on the world as a whole, these changes require necessarily Advancement of the profession of auditing, and improve their performance, especially after the mixer skepticism the health of approach and the method followed by a check in the major audit firms global view as for the external audit of an active role in providing services to members of the community in various sectors, were to be provide these services to the highest level of quality.To ensure the quality of the audit process to be a proper planning is based on a scientific basis to be the substrate a strong underlying different audit works, and if planni

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Thu Jan 01 2015
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Journal Of Chemical And Pharmaceutical Research
Studies on the interaction and effect of Mn(II), Fe(II), Co(II), Ni(II),Cu(II), Zn(II) and Cd(II) mixed- ligand complexes of cephalexin mono hydrate and furan-2-carboxylic acid to different DNA sources
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To evaluate the Interaction of Mn(II), Fe(II), Co(II), Ni(II),Cu(II), Zn(II) And Cd(II) Mixed- Ligand Complexes of cephalexin mono hydrate (antibiotics) And Furan-2-Carboxylic Acid To The Different DNA Sources. All the metal complexes were observed to cleave the DNA. A difference in the bands of complexes .The cleavage efficiency of the complexes compared with that of the control is due to their efficient DNA-binding ability and the other factors like solubility and bond length between the metal and ligand may also increase the DNA-binding ability. The ligands (Cephalexin mono hydrate (antibiotics) and Furan-2- Carboxylic acid and there newly synthesized metal complexes shows good antimicrobial activities and Binding DNA , thus, can be used

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Sat Jun 06 2026
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Some cognitive sense of kinesthetic and spatial relationship to the level of learning some skills in the ground dictated by hardwareResearch and descriptiveStudents on the third phase of the Faculty of Physical Education for Girls - University of Baghdad
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Publication Date
Fri Jul 01 2011
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Bulletin Of The Iraq Natural History Museum (p-issn: 1017-8678 , E-issn: 2311-9799)
CAVE DWELLING ANIMALS IN IRAQ PART 2: SYSTEMATIC NOTES ON THE NUTHATCH OF THE FAMILY SITTIDAE (AVESPASSERIFORMES) IN IRAQ WITH ADDING SOME IMPORTANT KNOWLEDGE TO THE NEST BUILDING OF SITTATEPHRONOTA SHARPE, FROM BESAN VALE HAWRAMAN SLOPE, IRAQI KURDISTAN
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This paper is a review of the genus Sitta in Iraq, Five species of this genus are recognized
Sitta kurdistanica, S. neumayr, S. europaea, S.dresseri and S. tephronota. Geographical
distribution and systematic nots were given for separation and identification, also some notes
on nest building and nest sites of S. tephronota supporting by figures are presented.

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