Anesthesia for Creation of a Forearm Fistula in Patients with Endstage Renal Failure

Mouquet, C.; Bitker, Marc Olivier; Bailliart, O; Rottembourg, J; Clergue, F.; Montejo, Lyem Salgado; Martineaud, J.P.; Viars, P.

doi:10.1097/00000542-198906000-00005

Cited by 67 publications

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“…1 AVF blood flow was shown to be significantly increased in patients having brachial plexus blockade when compared to those having general anesthesia in the immediate postoperative period. 2 Following AVF operations, physiotherapy is needed for a properly working fistula. For a better physiotherapy, motor functions of the muscles should be in good condition with a complete analgesia.…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Articaine and Fentanyl-Supplemented Articaine for Hemodialysis Fistula Creation under Ultrasound-Guided Axillary Block

et al. 2011

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The aim of this prospective randomized, double-blinded study was to evaluate the effect of fentanyl addition to articaine on the duration of sensory as well as motor blocks, and the duration of analgesia during hemodialysis fistula creation under ultrasound-guided axillary block. Fifty patients were randomly allocated to two groups, an articaine group (A), receiving 40 mL of articaine HCI (20 mg/mL) with 2 mL of isotonic sodium chloride solution, and an articainefentanyl group (AF), receiving 40 mL of articaine HCI (20 mg/mL) with 2 mL (100 μg) of fentanyl. The onset as well as the duration of sensory and motor blocks, the time necessary for first analgesic administration, the hemodynamic parameters, and the side effects were recorded. Three patients in Group A and two patients in Group AF due to incomplete block were excluded from the study. The duration of sensory and motor blocks was significantly longer in the AF group than in the A group. The first time for analgesic need was also significantly longer in group AF (363 ± 134 min) than in group A (244 ± 84 min) (p = 0.001). The addition of fentanyl did not improve the onset of sensory and motor block times. Hemodynamic parameters were similar in the two groups. In conclusion, the addition of fentanyl to articaine in axillary block prolongs the duration of sensory and motor blocks, as well as the time of first analgesic requirement.

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Section: Introductionmentioning

confidence: 99%

A Comparison of Articaine and Fentanyl-Supplemented Articaine for Hemodialysis Fistula Creation under Ultrasound-Guided Axillary Block

et al. 2011

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“…1 The 2000 National Confidential Enquiry into Perioperative Deaths (NCEPOD) Report recommends that asymptomatic cardiac murmurs should be investigated preoperatively by echocardiography [1]. The American College of Cardiology/American Heart Association (AHA) guidelines recommend preoperative echocardiography in patients with decompensated heart failure (class 1 evidence) and patients with previous episodes of heart failure (class 2a evidence) [2]. However, these recommendations have yet to be validated in clinical practice.…”

Section: Resultsmentioning

confidence: 99%

“…Brachial plexus block is a safe alternative to general anaesthesia in these patients [1]. It has been shown that the regional sympathetic block associated with brachial plexus block produces a greater increase in brachial artery blood flow than general anaesthesia with less systemic hypotension [2]. Therefore we hypothesised that the favourable peri-operative haemodynamics under brachial plexus block may influence the rates of fistula patency.…”

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confidence: 99%

Increased administration of oxygen improves cerebral oxygenation during carotid endarterectomy

et al. 2007

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Creation of an arteriovenous fistula is a common vascular procedure in patients with significant co-morbidities. Brachial plexus block is a safe alternative to general anaesthesia in these patients [1]. It has been shown that the regional sympathetic block associated with brachial plexus block produces a greater increase in brachial artery blood flow than general anaesthesia with less systemic hypotension [2]. Therefore we hypothesised that the favourable peri-operative haemodynamics under brachial plexus block may influence the rates of fistula patency. MethodsA prospective database of access surgery was used to identify 107 patients who had proximal radiocephalic, brachiocephalic and basilic transposition fistulas under general anaesthesia (n ¼ 75) or brachial plexus block (n ¼ 32) between 2003 and 2006. Anaesthetic technique was at the discretion of the anaesthetist at the time of surgery. Primary and secondary patency of the fistula and patients' survival are reported using Kaplan-Meier survival analysis (reported as cumulative outcomes at 12 months) and compared by the log rank test. ResultsPrimary failure occurred in 3/32 (9%) patients with brachial plexus block compared to 13/75 (17%) with general anaesthesia, although this did not reach statistical significance. There was an improvement in cumulative secondary patency in the brachial plexus block group compared to general anaesthesia (0.906 vs 0.597, respectively; p ¼ 0.04 (Fig. 1)). However, there was no difference in cumulative primary patency (0.574 vs 0.450; p ¼ 0.38) or cumulative patient survival (0.947 vs 0.696; p ¼ 0.99). DiscussionWe found a statistically significant improvement in the secondary patency of fistulae created under brachial plexus block compared with general anaesthesia. The optimum haemodynamics under brachial plexus block may be responsible for this effect. Other mechanisms may include prevention of chronic activation of the sympathetic nervous system. Brachial plexus block is a safe alternative to general anaesthesia that may offer benefits beyond the peri-operative period.

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“…Ancak Doppler USG kullanı-larak yapılan benzer çalışmalarda trombüs gelişimi benzer olsa da gruplardaki akım ve vasküler direnç değerleri farklı bulunmuştur. Akım farklı-lıklarının yalnızca fistül başarısını değil, aynı zamanda AVF olgunlaşma süresi ve uzun dönem başarısını da etkilediği belirtilmiştir (16,17). Hastalarımız dış merkezlerde de diyaliz tedavisi gördüğü için geç dönem takiplerimiz eksikti.…”

Section: Tablo-3unclassified

Effects of Anesthetic Technique on Arteriovenous Fistula Patency

Yümün¹,

Toktaş²,

Ay³

et al. 2012

Turk J Bioch

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Amaç: Bu çalışmanın amacı lokal anestezi ve aksiller anestezi uygulamasının arteriyovenöz fistül açıklığına etkisinin araştı-rılmasıdır. Yöntem: Kliniğimizde son bir yılda arteriyovenöz fistül açıl-mış 38 hasta retrospektif olarak değerlendirildi. Operasyon sonrası pulsasyon ve thril alınması başarılı sonuç olarak değerlendirildi. Bulgular: Hastalardan 24'ü lokal anestezi ile, 14'ü aksiler anestezi ile opere edildi. 3 hastaya ilk üç haftalık takiplerde arteriyovenöz fistülde diyaliz için yeterli akım oluşmadığın-dan revizyon gerekti. Bunlardan biri lokal anestezi grubunda, diğer ikisi aksiller anestezi grubundaydı. Sonuç: Sonuç olarak anestezi tekniğine bağlı arteiyovenöz fistül başarı oranlarının farklı olmadığı görüldü. Background:The aim of this study was to investigate the effect of local anesthesia and axillary anesthesia to AVF patency. Method: AVF opened 38 patients were examined in our clinic at the last one year, retrospectively. After the operation, pulsation, and thrill were evaluated as a successful outcome. Results: 24 Patients were operated with local anesthesia, and 14 were axillary anesthesia. 3 patients were needed revision because of insufficient flow in the first three weeks follow up. One of these patients is in axillary anesthesia group, the others were in local anesthesia group. Conclusion: As a result, there wasn't a different arteriovenous fistula success rates depending on the technique of anesthesia.

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Anesthesia for Creation of a Forearm Fistula in Patients with Endstage Renal Failure

Cited by 67 publications

References 0 publications

A Comparison of Articaine and Fentanyl-Supplemented Articaine for Hemodialysis Fistula Creation under Ultrasound-Guided Axillary Block

A Comparison of Articaine and Fentanyl-Supplemented Articaine for Hemodialysis Fistula Creation under Ultrasound-Guided Axillary Block

Increased administration of oxygen improves cerebral oxygenation during carotid endarterectomy

Effects of Anesthetic Technique on Arteriovenous Fistula Patency

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