Comparing the effectiveness of vapocoolant spray versus lidocaine spray on pain intensity due to insertion of vascular needles in hemodialysis patients

Comparison the effectiveness of vapocoolant versus lidocaine spray on pain intensity due to insertion of vascular needles in hemodialysis patients

The study is a three period cross over double blind randomized Clinical Trial which carry on 4 patients. Randomization is done via blocking and random numbers table.

The first needling is performed without any intervention, the pain score is determined one minute after needling.Each of the samples in the next dialysis randomly receives one of the following interventions: vapocoolant ,10% lidocaine spray and placebo(water) in 2 weeks intervals.Vapocoolant sprayed on the skin at a distance of 20 cm for 3 or 4 seconds, allowing the skin to dry for 10 seconds, then disinfect the skin (uniformly temperature-sensitive and uniform for all patients) and 20 seconds after, vascular access is done.Two puff lidocaine sprays are sprayed at approximately 5 cm, 5 minutes after spraying and after disinfection,vascular access is done by the nurse. Inusing the placebo spray, two puff are sprayed at a distance of 5 cm, 5 minutes after spraying and disinfection, vascular access is done.The outer part sprays is covered with paper.The coworker applied the spray to the skin and one minute after needling, the patient's pain score is determined by the presenter without the knowledge of the type of spray. In all patients, the size of needle is 16. In the total stages in each patient, one nurse will work. Nurse and patient will not be aware of the spray type.

All hemodialysis patients. Entering criteria: arteriovenous fistula.Not entering:cardiac disease,lidocain reaction

The samples in the next dialysis session randomly receives one of the following interventions:vapocoolant spray, 10% lidocaine spray and placebo spray.

Reducing the venous access pain

All patients undergoing hemodialysis with inclusion criteria are randomly assigned to three intervention groups. First, ABCs, BACs, ACBs, BCAs, CABs, CBAs, and CABs are considered and from zero to five number are allocated to each block, respectively (A vapocoolant spray group, B lidocaine sprays group, C placebo spray group). Then, from the random number table, the number of random samples according to sample size in each group is selected, after deleting the numbers from 6 to 9, is assigned to each corresponding block number. Then numbered and according to the list, patients are assigned to one of three groups.

Participants blinding (patients) and clinical caregiver: To prepare placebo sprays, we will empty the lid of lidocaine spray dish and spill it into it. The outer part of each of the three sprays is covered with paper to have an almost identical appearance. Outcome evaluator blinding: In all cases, the coolaborator applies the spray to the skin of the patients and the question of pain score is performed by the executor without notice of the type of spray used. When applying sprays, the executor is not present at the patient's bedside.