The alleviation of puncture pain by lidocaine/propitocaine cream (EMLA<sup>®</sup> cream) in 21 hemodialysis patients

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  • Uchimura Hideki
    Department of Nephrology, Kikuna Memorial Clinic
  • Yasuda Marie
    Department of Internal Medicine (Nephrology, Endocrinology, and Metabolism), Keio University School of Medicine
  • Uchiyama Kiyotaka
    Department of Internal Medicine (Nephrology, Endocrinology, and Metabolism), Keio University School of Medicine
  • Ito Tomoaki
    Department of Internal Medicine (Nephrology, Endocrinology, and Metabolism), Keio University School of Medicine
  • Tajima Takaya
    Department of Internal Medicine (Nephrology, Endocrinology, and Metabolism), Keio University School of Medicine
  • Hishikawa Keiichi
    Department of Internal Medicine (Nephrology, Endocrinology, and Metabolism), Keio University School of Medicine
  • Abe Mizuho
    Department of Clinical Engineering, Kikuna Memorial Clinic
  • Yoshiyama Mayu
    Department of Nursing, Kikuna Memorial Clinic
  • Kawachi Mayumi
    Department of Pharmacy, Kikuna Memorial Clinic

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Other Title
  • リドカイン-プロピトカイン配合クリーム (エムラ<sup>®</sup>クリーム) による透析穿刺痛の緩和
  • リドカイン-プロピトカイン配合クリーム(エムラクリーム)による透析穿刺痛の緩和
  • リドカイン-プロピトカイン ハイゴウ クリーム(エムラクリーム)ニ ヨル トウセキ センシツウ ノ カンワ

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Abstract

<p>In hemodialysis, the insertion of a large needle 6 times a week inevitably results in puncture pain (nociceptive pain). This pain is one of the most serious worries among hemodialysis patients. A lidocaine/propitocaine cream (EMLA® cream) that markedly reduces the severity of such puncture pain has recently been approved in Japan. This report describes its effects on puncture pain at our hemodialysis clinic. Lidocaine/propitocaine cream was applied to puncture sites on the forearms/upper arms of 21 hemodialysis patients whose pain had not been alleviated sufficiently by lidocaine tape. The degree of the subjects' puncture pain was quantitatively assessed using a numerical rating scale (NRS). The mean NRS score fell significantly (p<0.0001) from 8.0±1.2 after the use of lidocaine tape to 2.1±2.2 after the application of lidocaine/propitocaine cream. The use of the lidocaine/propitocaine cream resulted in “pain-free hemodialysis”; i.e., the “loss of nociceptive pain during venipuncture in hemodialysis” . Such pain not only impairs the quality of life (QOL) of hemodialysis patients but also disturbs homeostasis. Therefore, healthcare professionals should manage puncture pain properly. Lidocaine/propitocaine cream markedly alleviated puncture pain in hemodialysis patients and improved their QOL.</p>

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