COMPARATIVE EFFECT OF LIDOCAINE SPRAY, COLD PACKS, AND FLASHLIGHT DISTRACTION ON ARTERIOVENOUS FISTULA CANNULATION PAIN IN HEMODIALYSIS PATIENTS: A PROSPECTIVE WITHIN-SUBJECT CONTROLLED TRIAL

Authors

  • MOHAMMED MURTADHA Department of Clinical Pharmacy, College of Pharmacy, AL-Nahrain University, Baghdad, Iraq. https://orcid.org/0009-0002-2249-5748
  • MOHANAD ABDULSAHIB ZABOON Department of Clinical Pharmacy, College of Pharmacy, AL-Nahrain University, Baghdad, Iraq.
  • SABA HAMEED Department of Clinical Pharmacy, College of Pharmacy, AL-Nahrain University, Baghdad, Iraq.
  • HIBA MURTADHA AL-SAADI Department of Clinical Pharmacy, College of Pharmacy, AL-Nahrain University, Baghdad, Iraq.
  • AHMED M. ALCHARRAKH Department of Clinical Pharmacy, College of Pharmacy, AL-Nahrain University, Baghdad, Iraq
  • FARIDA ISLAHUDIN Center of Quality Medicine Management, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. https://orcid.org/0000-0002-4450-4361

DOI:

https://doi.org/10.22159/ajpcr.2026v19i4.58388

Keywords:

Hemodialysis, Arteriovenous fistula, Cannulation pain, Pain management,, Lidocaine spray, Cold pack/Cryotherapy, Flashlight distraction

Abstract

Objective: Arteriovenous fistula (AVF) cannulation pain remains a major challenge in the care of hemodialysis (HD) patients. This study aimed to compare the effectiveness of three non-pharmacological interventions – lidocaine spray, cold packs, and flashlight distraction – in reducing AVF cannulation pain in Iraqi HD patients.

Methods: A prospective within-subject controlled trial was conducted at Al-Kadhmia Hospital in Baghdad. Thirty-five male HD patients with AVFs participated in a 4-week within-subject design study. Week 1 served as the control with no intervention, while lidocaine spray, cold packs, and a flashlight were applied, respectively, in weeks 2, 3, and 4 before cannulation. Pain was assessed using the Visual Analog Scale (VAS) after each session.

Results: A significant difference was observed between the four conditions (F[3,102]=23.687, p<0.001). Mean VAS scores were highest in the control group (6.11±1.05), followed by flashlight (5.71±0.86), cold packs (5.11±1.05), and lidocaine (5.00±1.14). All three interventions significantly reduced pain compared with control (p<0.001), with lidocaine demonstrating the greatest reduction.

Conclusion: Lidocaine spray, cold packs, and a flashlight can significantly reduce cannulation pain in HD patients, with lidocaine being the most effective. These findings support incorporating simple, low-cost interventions into HD care to enhance patient comfort.

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Published

07-04-2026

How to Cite

MOHAMMED MURTADHA, et al. “COMPARATIVE EFFECT OF LIDOCAINE SPRAY, COLD PACKS, AND FLASHLIGHT DISTRACTION ON ARTERIOVENOUS FISTULA CANNULATION PAIN IN HEMODIALYSIS PATIENTS: A PROSPECTIVE WITHIN-SUBJECT CONTROLLED TRIAL”. Asian Journal of Pharmaceutical and Clinical Research, vol. 19, no. 4, Apr. 2026, pp. 64-68, doi:10.22159/ajpcr.2026v19i4.58388.

Issue

Vol 19 Issue 4 April 2026

Section

Original Article(s)

Copyright (c) 2026 MOHAMMED MURTADHA, MOHANAD ABDULSAHIB ZABOON, SABA HAMEED, HIBA MURTADHA AL-SAADI, AHMED M. ALCHARRAKH, FARIDA ISLAHUDIN

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