Ultrasound-guided supraclavicular brachial plexus block for analgesia during endovascular treatment of dysfunctional hemodialysis fistulas

J Vasc Interv Radiol. 2014 Sep;25(9):1427-32. doi: 10.1016/j.jvir.2014.05.007. Epub 2014 Jun 27.

Abstract

Purpose: To evaluate prospectively the efficacy and safety of ultrasound (US)-guided supraclavicular brachial plexus block (BPB) for analgesia during endovascular treatment of dysfunctional hemodialysis fistulas.

Materials and methods: US-guided supraclavicular BPB was performed before endovascular treatment of dysfunctional hemodialysis fistulas in 40 consecutive patients. After BPB, standard interventional procedures were performed for treatment of dysfunctional hemodialysis fistulas. A visual analog scale (0-10) was used to assess pain related to performance of BPB immediately after the endovascular procedure. Patient satisfaction and operator satisfaction during the procedure were also assessed after the procedure.

Results: Satisfactory regional anesthesia and analgesia were achieved in all patients without a need for supplemental intravenous analgesia. The mean onset time for complete block was 5.4 minutes ± 2.6. Pain scores were 0 (no pain) in 26 patients and 1-3 (mild, annoying pain) in 14 patients. The patient's satisfaction with pain control was recorded as satisfied (very well) in all cases. The operator's satisfaction with this anesthetic technique was also recorded as satisfied (very well) in all cases. Complications related to the block procedure did not occur in any patient.

Conclusions: US-guided supraclavicular BPB can be used safely to provide analgesia during endovascular treatment of dysfunctional hemodialysis fistulas in adult patients.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arteriovenous Shunt, Surgical / adverse effects*
  • Brachial Plexus Block* / adverse effects
  • Endovascular Procedures* / adverse effects
  • Female
  • Graft Occlusion, Vascular / diagnosis
  • Graft Occlusion, Vascular / etiology
  • Graft Occlusion, Vascular / therapy*
  • Humans
  • Male
  • Middle Aged
  • Pain / diagnosis
  • Pain / etiology
  • Pain / prevention & control*
  • Pain Measurement / adverse effects
  • Pain Measurement / methods*
  • Patient Satisfaction
  • Prospective Studies
  • Renal Dialysis*
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Interventional* / adverse effects
  • Young Adult