Cooling spray or lidocaine spray and needle insertion pain in hemodialysis patients: an open-label cross-over randomized clinical trial

The needle insertion pain to perform hemodialysis is the main challenge and a common problem that requires pain management techniques for patients' comfort. This study aimed to compare the effects of cooling and lidocaine sprays on needle insertion pain in hemodialysis patients. In this randomized cross-over clinical trial study, the hemodialysis patients were selected through convenience sampling according to inclusion criteria and randomly assigned to three intervention groups using the block randomization method. Each patient received three interventions in a cross-over design: Cooling spray or 10% lidocaine spray or placebo spray. There was a 2-week wash-out time between each intervention. The pain score was measured four times for each patient by the Numerical Rating Scale. Forty-one hemodialysis patients were included. The results showed a significant interaction between time and group (p