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.