RecruitingACTRN12622000943741

Comparison of EMLA cream with piroxicam gel for reducing pain associated with needling of arteriovenous fistula during haemodialysis

Comparison of prilocaine/ lidocaine cream with piroxicam gel for reducing pain during cannulation of arteriovenous fistula for adults with end stage renal disease undergoing haemodialysis

Sponsor

Samia Shaheen

Enrollment

16 participants

Start Date

Jun 20, 2022

Study Type

Interventional

Conditions

Haemodialysis

Summary

Pain during needling of arteriovenous fistulas is problematic for most of the patients. This study aims to compare two strategies to reduce this: dermal application of prilocaine/ lignocaine cream or piroxicam gel at the local site one hour before the dialysis session. Patients would receive both these medicines sequentially, though they would not be knowing which medicine they have received. We will compare the degree of pain perceived during needling and compare the two treatment options. It is hypothesized that prilocaine/ lignocaine cream is superior to piroxicam gel for reducing pain during cannulation of arteriovenous fistula.

Eligibility

Sex: Both males and femalesMin Age: 18 YearssMax Age: 75 Yearss

Inclusion Criteria1

Patients with end stage renal disease, undergoing haemodialysis with a native upper limb arteriovenous fistula

Exclusion Criteria7

Use of tunnelled dialysis catheters or arteriovenous grafts for haemodialysis
Unwilling patients
Known Hypersensitivity to any ingredient of the agents
Patients with ulcer/ wound at fistula site
Neuropathies causing loss of pain sensation
Atopic dermatitis
Co-morbidity resulting in participants' inability to validating the visual analog scale, e.g.,altered sensorium, psychiatric patients

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Interventions

EMLA cream is a combination of two local anaesthetic agents (Prilocaine 2.5% and Lidocaine 2.5%) which is relatively easy to apply on arteriovenous fistula site. The patients will clean the skin at local site with alcohol swab and then apply a standard dose of 2.5 grams EMLA cream in a thin layer sixty minutes before reaching the dialysis unit. This would be covered with an adhesive tape provided to the patients. Arteriovenous fistulas would be punctured with 17G Fistula needles by trained staff. Patients would do this twice in successive haemodialysis session. Adherence to intervention would be monitored through regular inspections carried out before start of haemodialysis sessions by the dialysis nurses. Following these two haemodialysis sessions, there would be a wash out period of one week before the participants get shifted to the other intervention group. During this week, no medicines would be applied locally.