Observational study of the efficacy of supraclavicular brachial plexus block for arteriovenous fistula creation

摘要

Background and Aims: Arteriovenous (AV) fistula surgery is commonly performed for AV access for hemodialysis. However the ideal anaesthetic technique of choice remains debated. We aimed to assess operative conditions, vascular patency, and complication rate following AV fistula surgery with isolated brachial plexus block among end-stage renal disease (ESRD) patients. Methods: This prospective, observational study included 214 patients undergoing AV fistula surgery under isolated supraclavicular brachial plexus block between January and December 2017. The diameters of the vessels both before and after the block, and the patency of the AV fistula in the immediate postoperative period and after 3 months were assessed using ultrasound Doppler. The change in the vessel diameter both before and after block was compared using independent sample t-test. Results: The mean brachial artery diameter increased by 0.09 mm (P = 0.002), and cephalic vein diameter at elbow, radial artery, and cephalic vein at wrist diameters increased by 0.5 mm (P P = 0.031), and 0.48 mm (P Conclusion: Ultrasound-guided isolated brachial plexus block results in good vasodilation and achieves good immediate and long-term patency in AV fistula surgery.