Comparison between Local and Regional Anesthesia in Arteriovenous Fistula Creation

Monte, Attilio Ignazio Lo; Damiano, Giuseppe; Mularo, A.; Palumbo, Vincenzo Davide; Alessi, Rosi; Gioviale, Maria Concetta; Spinelli, Gabriele; Buscemi, Giuseppe

doi:10.5301/jva.2011.8560

Cited by 34 publications

(43 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, a report by Malovrh [14] revealed a mean preoperative flow rate of 54.5 ml/min in BPB vessels with a successful outcome versus 24.1 ml/min in vessels that failed LA. In another study by Sahin et al [3], improved blood flow in the radial artery was significantly greater post-versus preanesthesia. Moreover, post-anesthesia and just pre-surgery, radial artery blood flow was 56 8.6 mL/min in the BPB group versus 40.7 6.1 mL/min in the LA group (P 0.001).…”

Section: Discussionmentioning

confidence: 88%

“…Axillary-approached BPB (RA) was preferable to LA. Arterial and venous dilation are crucial for AVF maturation [3] yet vascular surgery, such as local infiltration anesthesia, can easily lead to vessel spasm, impairing blood flow and potentially resulting in early fistula thrombosis. Comparatively, BPB can be performed using interscalene, supraclavicular, infraclavicular, and axillar approaches [5].…”

Section: Discussionmentioning

confidence: 99%

“…In total, 7 studies, including 852 patients [3,4,[6][7][8][9][10], evaluated primary patency rates in RA versus LA; RA was associated with higher primary patency rates than LA (OR, 1.88; 95% CI, 1.24-2.84; P = 0.003; I 2 , 31%; Fig. 3).…”

Section: Clinical Outcomesmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of regional and local anesthesia for arteriovenous fistula creation in end-stage renal disease: a systematic review and meta-analysis

Chen

Weng

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Arteriovenous fistulae (AVF) are the hemodialysis access modality of choice for patients with end-stage renal disease. However, they have a high early failure rate. Good vascular access is essential to manage long-term hemodialytic treatment, but some anesthesia techniques directly affect venous diameter as well as intra- and post- operative blood flow. The main purpose of this meta-analysis was to compare the results of regional and local anesthesia for arteriovenous fistula creation in end-stage renal disease.Methods: We conducted a systematic review and meta-analysis to synthesize evidence from 7 randomized controlled trials (565 patients) and 2 observational studies (524 patients) aim to evaluate the safety and efficacy of regional anesthesia (RA) versus local anesthesia (LA) in AVF surgical construction.Results: Pooled data showed that RA was associated with higher primary patency rates than LA (odds ratio [OR], 1.88; 95% confidence interval [CI], 1.24 - 2.84; P = 0.003; I 2 = 31%; Figure 2a). Additionally, brachial artery diameter was significantly increased in the RA versus LA group (mean difference [MD] = 0.83; 95% CI: 0.75 - 0.92; P < 0.001; I 2 = 97%) and the need for intra- as well as post- operative pain killers was significantly less (RA, p = 0.0363; LA, p = 0.0318). Moreover, operation duration was significantly reduced in the RA (67.5 ± 8.9 min) versus LA (134.7 ± 14.8 min) group (p = 0.0007).Conclusions: In conclusion, compared with LA, RA shows higher primary patency rates and it also associated with significantly better intra- as well as post- operative pain control, reduced operative times, which are extremely important in patients with end-stage renal disease and severe comorbidities.

show abstract

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of regional and local anesthesia for arteriovenous fistula creation in end-stage renal disease: a systematic review and meta-analysis

Chen

Weng

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…There were several limitations in our study. First, although there were 20 patients in each group, which is su cient according to a previous study 14 , this was still a small sample size. Second, this was a nonrandomised control prospective observational study.…”

Section: Discussionmentioning

confidence: 99%

Is Wide-Awake Local Anesthesia No Tourniquet Technique in Distal Radius Plating Surgery a Comfortable Procedure? A Prospective Case-Control Study

Lu¹,

Liu²,

Lu³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Wide-awake local anesthesia no tourniquet (WALANT) is a promising technique for bony procedure in recent years. During distal radius surgery via WALANT technique, surgeons may concern about intraoperative pain. This prospective case-control study was aimed to compare the intraoperative hemodynamic changes between WALANT technique and general anesthesia (GA) in patients undergoing distal radius plating surgery.Methods: We recruited 40 adults with distal radius fracture underwent plating using the WALANT technique (group A) or general anesthesia (group B). Each group comprised 20 patients with similar demographics. Mean arterial pressure (MAP) and heart rate were recorded in both groups. Intraoperative pain intensity was measured by numeric rating scale (NRS) for pain in group A.Results: The NRS decreased significantly compared with preoperative status in group A for most of the intraoperative period. The intraoperative MAP in group A showed no significant change among each peri-operatively period. In addition, group A showed less peri-operative MAP fluctuation than group B (p< 0.05). The intraoperative changes in HR showed significant changes between group A and B during reduction, plating and skin closure. The reduction and plating quality were similar between each group.Conclusions: Patients undergoing distal radius plating surgery via WALANT technique has a lower MAP changes. Distal radius plating surgery using the WALANT technique is a well-tolerated surgical procedure and showing the similar reduction and plating quality to through GA.

show abstract

“…Arteriovenous fistula (AVF) surgery can be performed success-fully under local anesthesia or BPB. However, BPB offers several advantages compared with local anesthesia [6,7]. We report on a case in which the spasticity of the right shoulder increased after ipsilateral BPB in a patient with right hemiplegia following an intracranial hemorrhage.…”

Section: Introductionmentioning

confidence: 93%

Exacerbation of spasticity in ipsilateral shoulder after right brachial plexus block in a patient with right hemiplegia

Park

Baek

2015

Yeungnam Univ J Med

View full text Add to dashboard Cite

Spasticity is a common impairment in patients with central nervous system disease. Clinical observation has demonstrated that spasticity can be aggravated by various factors such as emotional state as well as noxious stimuli. A 51-year-old male patient was scheduled for arteriovenous fistula surgery. He had right hemiplegia including motor weakness and spasticity. It was decided that the surgery would be performed under an axillary brachial plexus block (BPB). He appeared nervous when blockade was terminated. The spasticity of the right shoulder increased after ipsilateral BPB. However, when we administered sedative drugs and performed interscalene BPB 2 days later, spasticity did not occur. Exacerbation of spasticity might be evoked by an anxious emotional state. Thus, it seems to be good to consider removing of anxiety and using an appropriate approach when it is tried to perform nerve blocks in individuals with spasticity.

show abstract

Comparison between Local and Regional Anesthesia in Arteriovenous Fistula Creation

Cited by 34 publications

References 9 publications

Comparison of regional and local anesthesia for arteriovenous fistula creation in end-stage renal disease: a systematic review and meta-analysis

Comparison of regional and local anesthesia for arteriovenous fistula creation in end-stage renal disease: a systematic review and meta-analysis

Is Wide-Awake Local Anesthesia No Tourniquet Technique in Distal Radius Plating Surgery a Comfortable Procedure? A Prospective Case-Control Study

Exacerbation of spasticity in ipsilateral shoulder after right brachial plexus block in a patient with right hemiplegia

Contact Info

Product

Resources

About