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Saudi Journal of Kidney Diseases and Transplantation
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ORIGINAL ARTICLE Table of Contents   
Year : 2020  |  Volume : 31  |  Issue : 3  |  Page : 597-603
Management of pain at arteriovenous fistula puncture: Cryotherapy versus lidocaine/prilocaine

Department of Nephrology, Dialysis and Renal Transplantation, Ibn Rochd University Hospital; Faculty of Medicine and Pharmacy of Casablanca, Hassan II University, Casablanca, Morocco

Correspondence Address:
Loubna Kortobi
Department of Nephrology, Dialysis and Renal Transplantation, Ibn Rochd University Hospital, Casablanca
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-2442.289446

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Pain at arteriovenous fistula (AVF) puncture is common in hemodialysis (HD) patients. The purpose of our work is to determine its frequency, to evaluate the efficiency of two techniques: anesthetic cream (Emla™) and cryotherapy, and to compare their efficiency. A prospective and interventional analytical study of HD patients was conducted in our structure. We included all patients with pain at AVF puncture. We evaluated the pain intensity using a visual analogue scale before and after our intervention: Emla™ cream during three consecutive HD sessions, then cryotherapy (ice cubes placed in latex gloves, during 5 min, directly applied on the puncture sites) during three consecutive HD sessions. The statistical analysis was performed using the Epi Info software. Eighty-four patients are undergoing HD in our structure, of which 32 (38%) report pain at AVF puncture. The mean value of the visual analog scale before the puncture was 7.19 ± 1.95 (4-10). Pain decrease was statistically significant for both techniques. Comparative analysis of the two techniques revealed a significant reduction in pain in favor of cryotherapy (P 0.001). The analgesic effect has been proved for both techniques. Cryotherapy provides higher efficiency, with fewer constraints, and could be proposed for the management of pain at AVF puncture.

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