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ePublished: 20 Jul 2017
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J Renal Inj Prev. 2017;6(4): 269-274.
doi: 10.15171/jrip.2017.51

Scopus ID: 85040739429
  Abstract View: 2220
  PDF Download: 1332

Original Article

Efficacy of application of eutectic mixture of local anesthetics and lidocaine spray in pain management of arteriovenous fistula cannulation in hemodialysis patients

Samaneh Mirzaei 1, Mostafa Javadi 1 * , Adel Eftekhari 2, Maryam Hatami 3, Roya Hemayati 4

1 Department of Nursing, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2 Department of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
3 Department of Anesthesiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
4 Department of Internal Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
*Corresponding author: Mostafa Javadi, 1

Abstract

Introduction: The hemodialysis patients frequently experience the pain and anxiety induced by arteriovenous fistula (AVF) cannulation. This painful intervention, if repeated, imposes destructive psychosomatic effects on patients. Hence, the use of appropriate procedures to reduce pain in these patients is of utmost importance.

Objectives: The present study aimed at investigate efficacy of lidocaine spray and topical eutectic mixture of local anesthetics (EMLA) cream in releiving pain induced by arteriovenous fistula cannulation in hemodialysis patients.

Patients and Methods: This quasi-experimental study was conducted on 40 patients with arteriovenous fistula (AVF) selected on the basis of purposive sampling method in 2015 in hemodialysis ward of Shahid-Sadoughi hospital. Pain severity was measured at AVF cannulation using EMLA analgesic cream and lidocaine spray with the pain severity numerical scale. Repeated measures analysis of variance (ANOVA) was used in data analysis using SPSS 16.

Results: Findings showed that the mean scores of the three methods of pain management, i.e., no pain control method, lidocaine spray, and EMLA analgesic cream, were 7.45±0.88, 4.22±1.33, and 2.8±0.70, respectively. There was a considerable reduction in pain severity using the lidocaine spray and EMLA analgesic cream compared to the conventional method (P<0.001). EMLA analgesic cream caused a greater reduction in pain rate compared to lidocaine spray (P<0.001).

Conclusion: This study suggested that EMLA analgesic cream was more effective in reducing pain caused by AVF cannulation. Hence, it is recommended that the hemodialysis patients apply EMLA analgesic cream themselves at the time of the procedure to reduce the cannulation pain.

Keywords: Hemodialysis, Arteriovenous fistula cannulation, Lidocaine, Pain

Implication for health policy/practice/research/medical education:

In the current study, we intended to measure pain associated with AVF cannulation and to compare the effectiveness of lidocaine spray and topical EMLA cream in controlling pain caused by venepuncture of AVF patients undergoing chronic hemodialysis. This study points out the need for an effective pain assessment before the AVF puncture, which can serve as a starting point for the elaboration of protocols for pain management in hemodialysis. We suggest experimental studies to compare different pharmacological and non-pharmacological approaches as alternatives to minimize pain.

Please cite this paper as: Mirzaei S, Javadi M, Eftekhari A. Efficacy of application of eutectic mixture of local anesthetics and lidocaine spray in pain management of arteriovenous fistula cannulation in hemodialysis patients. J Renal Inj Prev. 2017;6(4):269- 274. DOI: 10.15171/jrip.2017.51.

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