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Medial and Lateral Antebrachial Cutaneous Nerve Blocks: An Easily Learned Regional Anesthetic for Forearm Arteriovenous Fistula Surgery
  1. Christopher M. Viscomi, M.D.,
  2. Jeffrey Reese, M.D. and
  3. James P. Rathmell, M.D.
  1. University of Vermont College of Medicine, Burlington, Vermont
  1. Reprint requests: Christopher M. Viscomi, M.D., Department of Anesthesiology, Medical Center Hospital of Vermont, Burlington, VT 05401.


Background and Objectives Forearm arteriovenous fistula insertion is commonly performed to facilitate hemodialysis. This study was undertaken to assess the use of medial and lateral antebrachial cutaneous nerve blocks to provide anesthesia for this surgery.

Methods Twelve patients with end-stage renal failure, presenting for insertion or revision of a forearm Gortex arteriovenous fistula, were anesthetized by local block of the medial and lateral antebrachial cutaneous nerves with a mepivacaine-bupivacaine mixture.

Results Ten patients required no further local anesthetic for surgery. Two patients required minor local anesthetic supplementation in the proximal radial nerve distribution.

Conclusions Anesthesia for forearm arteriovenous fistula insertion can be provided by an easily performed regional anesthetic technique, which may have advantages over brachial plexus blocks and incisional field blocks.

  • local anesthesia
  • nerve block
  • surgical arteriovenous shunt
  • kidney failure

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  • The work was performed at the Medical Center Hospital of Vermont, University of Vermont College of Medicine, Burlington, Vermont.