Randomized controlled study evaluating the efficacy of different lidocaine preparations to manage arteriovenous fistula puncture site pain in patients undergoing hemodialysis

Objective: We aimed to observe the analgesic efficacy of lidocaine to manage arteriovenous fistula (AVF) puncture site pain. Methods: We studied 120 patients with AVF puncture site pain who were randomly divided into 4 groups: the cream group (A), the spray group (B), the wet compression dressing group (C), and the control group (D). The visual analogue scale (VAS) pain score, puncture success rate, analgesic onset time, degree of patient satisfaction, and adverse reactions were compared between the 4 groups. Results: The percentage of the VAS pain score in group A (26.67%) was lower than in group B (33.33%) and group C (40.00%), and the values observed in all 3 groups were lower than in group D (100%). A significant difference in the degree of pain was observed between the 4 groups (chi(2) = 25.595, P < 0.001). Results in group A were better than in group B, C, and D; however, there was no significant difference observed in the post-intervention AVF puncture success rate between the 4 groups (chi(2) = 3.00, P = 0.392 > 0.05). The analgesic onset time in group B (6.90 +/- 2.54 min) was statistically shorter than in group C (10.00 +/- 2.58 min) and group A (55.78 +/- 19.98 min). The degrees of patient satisfaction in group A (96.67%), B (90.00%), and C (90.00%) were higher than in group D (63.33%) (Fisher exact test = 13.053, P = 0.003), and the value observed in group A was significantly higher than that observed in group D (chi(2) = 10.417, P = 0.002 < 0.0083). Conclusions: We observed that the 3 dosage forms of lidocaine studied can be effectively used to manage AVF puncture site pain. We observed that the cream preparation showed a slower onset of action, but a better analgesic effect, and the spray preparation showed a much more rapid onset of action.