Investigation of the Effect of EMLA Cream, Lidocaine Spray, and Ice Pack on the Arteriovenous Fistula Cannulation Pain Intensity in Hemodialysis Patients

Introduction: Arteriovenous fistula cannulation is one of the problems in hemodialysis patients. Reducing this pain improves their dialysis acceptance and life quality. This study investigated the effect of EMLA cream, Lidocaine spray, and ice pack on arteriovenous cannulation pain intensity in hemodialysis patients. Materials and Methods: A total of 40 hemodialysis patients with arteriovenous fistula participated in this quasi-experimental study in Shahid Rahnemoon Hospital in Yazd in 2015. In this study, pain intensity was measured in one group in four states of before intervention and after application of lidocaine spray, EMLA cream, and ice pack using pain intensity numerical scale. The data were analyzed with SPSS16 using ANOVA. Results: Our findings suggested that the mean pain score in the four stages of before intervention, and after application of lidocaine spray, ice pack, and EMLA cream were 7.45 ± 0.88, 4.22 ± 1.33, 5.38 ± 0.83, and 2.80 ± 0.70, respectively. The reduction in mean pain intensity was significantly greater with EMLA cream compared to lidocaine spray and ice pack (P<0.001). The pain score was also significantly different before intervention and after application of the three interventions (P<0.001). Conclusion: The results showed that all three methods of intervention were effective in reducing pain intensity, with EMLA cream exerting the greatest effect in decreasing the puncture-related mean pain intensity of arteriovenous fistula cannulation. So, it is recommended that all three methods be used to diminish this type of pain.

Hemodialysis, Arteriovenous fistula, Lidocaine, EMLA cream, Cryotherapy, Pain