Impact of ultrasound guided interscalene versus axillary brachial plexus block on patency rate of arteriove-nous fistula
10.3969/j.issn.1006-5725.2025.09.004
- VernacularTitle:超声引导下肌间沟与腋路臂丛神经阻滞对终末期肾病患者动静脉内瘘成形术通畅率的影响
- Author:
Chi ZHANG
1
;
Xiao LI
;
Xiang WEI
;
Gangyi CHEN
;
Hongmei LI
;
Kejia WANG
;
Junyi ZHENG
Author Information
1. 广州中医药大学第一临床医学院(广东 广州 510405)
- Publication Type:Journal Article
- Keywords:
autogenous arteriovenous fistula;
end-stage renal disease;
interscalene brachial plexus block;
axillary brachial plexus block
- From:
The Journal of Practical Medicine
2025;41(9):1293-1298
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the safety and efficacy of various brachial plexus block techniques using local anesthesia(LA)in patients undergoing their first radiocephalic arteriovenous fistula(RCAVF)surgery.Methods Patients were randomly allocated into three groups:LA,interscalene brachial plexus block(ISBPB),and axillary brachial plexus block(ABPB).Ultrasound was utilized to evaluate the pre-and post-anesthesia changes in vessel diameter and blood flow.Postoperative follow-up assessments were performed at three days and three months to determine fistula patency.Results Immediate patency rates were 92.52％(LA),96.26％(ISBPB),and 95.33％(ABPB),with no statistically significant differences among the groups(χ2=1.615,P=0.446).However,at three months,primary patency rates differed significantly among the groups(χ2=22.691,P<0.001).Specifically,the ISBPB group(83.18％)exhibited significantly higher patency compared to the LA group(57.01％)(χ2=17.477,P<0.001).Similarly,the ABPB group(80.37％)demonstrated better patency than the LA group(χ2=13.580,P<0.001).Regarding respiratory complications,they were more prevalent in the ISBPB group(15.89％)compared to the LA group(2.80％)(χ2=9.761,P=0.002)and the ABPB group(0.93％)(χ2=14.377,P<0.001).No significant difference was observed between the LA and ABPB groups in terms of respiratory complications(χ2=1.019,P=0.313).Conclusions Both ISBPB and ABPB demonstrated superior primary patency compared to LA.Nevertheless,ABPB exerted a lesser impact on respiratory function and provided a more comfortable surgical experience for ESRD patients.
