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ESRA19-0451 Regional anaesthesia for arterio-venous fistula in end stage renal failure patients
  1. C Srinath
  1. Leeds Teaching Hospitals NHS Trust, Anaesthesia, Leeds, UK


Background and aims End stage renal failure (ESRF) patients need vascular access for haemodialysis. Arterio-venous fistula (AVF) is most commonly used access for haemodialysis. AVF have high failure rate of 30–40% which could be due to failed maturation or thrombosis. The choice of anaesthetic technique for fistula formation can be local or regional or general anaesthesia. General anaesthesia can be associated with complications as these patients have several comorbidities. Local anaesthesia infiltration can result in vasospasm. Regional anaesthesia (RA) has a good safety profile and provides excellent anaesthesia and analgesia.

Methods We studied 10 patients in ESRF coming for the formation of primary AVF. Cephalic vein and brachial artery sizes were measured at the elbow pre block and post block. Lignocaine 2% with adrenaline was used for the block.

Results RA resulted in vasodilatation of the vessels. There was greater increase in diameter of cephalic vein than brachial artery. The average increase in size of cephalic vein was 14.8% and brachial artery was 6.4%.

Abstract ESRA19-0451 Figure 1
Abstract ESRA19-0451 Figure 2

Conclusions RA causes vasodilation which can assist the surgeon intraoperatively. This increase in diameter of the vessels can result in higher flow rates by avoiding vasospasm and helping to maintain patency by preventing thrombosis resulting in better patient outcome. This can assist in early maturation of fistula and prevent failure. With RA, patients can be discharged home the same day resulting in higher patient satisfaction and reduced health care costs.

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