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Official publication of the Indian Society of Nephrology
 
ORIGINAL ARTICLE
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Analgesia for pediatric arteriovenous fistula cannulation in hemodialytic patients: A comparison of lidocaine gel, lidocaine spray, and needle plate


1 Department of Community Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran
2 Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
3 Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
4 Department of Pediatrics, Mashhad University of Medical Sciences, Mashhad, Iran
5 Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Correspondence Address:
Anoush Azarfar,
Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad
Iran
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijn.IJN_151_20

Background: Children undergoing hemodialysis (HD) via arteriovenous fistula (AVF) experience approximately 300 painful punctures per year which may lead to non-compliance with HD. This study was conducted to show the effect of local anesthetics on pain perception in AVF cannulation. Methods: This randomized clinical trial included 20 children under HD via AVF in Sheikh Children's Hospital Hemodialysis Center in February 2014. The first intervention was conducted as the baseline pain assessment (control), then every patient randomly received all three other interventions: Lidocaine gel, lidocaine spray, and needle plate, before venipuncture. Pain perception was expressed and recorded by patients using the visual analogue scale (VAS). VAS scores were compared, and a P value of <0.05 was considered significant. Results: The VAS mean in lidocaine spray state, lidocaine gel state, and needle plate state was respectively 47.87, 51.31, and 49.43, which were significantly less than the control state with the VAS mean of 60.06 (lidocaine spray vs. control P value = 0.001, lidocaine gel vs. control P value = 0.001, and needle plate vs. control P value = 0.003). Conclusion: Our study showed that the use of needle plate, lidocaine spray, and lidocaine gel are all equally effective ways in controlling the degree of pain in AVF needling in children undergoing HD.


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    -  Ravanshad Y
    -  Golsorkhi M
    -  Ravanshad S
    -  Azarfar A
    -  Esmaeeli M
    -  Ghodsi A
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Indian Journal of Nephrology
Published by Wolters Kluwer - Medknow
Online since 20th Sept '07