Could anaesthetic technique be blocking successful outcomes in arteriovenous fistula surgery?

Macfarlane, Alan; Neuman, Mark D.; Aitken, Emma

doi:10.1016/j.bja.2020.10.014

Cited by 2 publications

(1 citation statement)

References 27 publications

(15 reference statements)

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“…In arteriovenous stula surgery, brachial plexus block increases tissue oxygenation in the innervated limb. In arteriovenous stula surgery, the application of a brachial plexus block for anesthesia has been shown to increase tissue oxygenation, as indicated by Near-Infrared Spectroscopy (NIRS), in the extremity innervated by the plexus (43,44). Supraclavicular and interscalene blocks are advanced anesthesia techniques.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Anesthesia Methods on the Prognosis of Elderly Patients Undergoing Upper Limb Surgery: A Systematic Review

Yin,

Wally,

OLAGUNJU

et al. 2024

Preprint

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Background The geriatric population presents unique challenges in the perioperative setting due to age-related physiological changes, comorbidities, and altered drug responses. Adapting anesthesia to the particular requirements of elderly patients is crucial for maximizing the success of surgical procedures and reducing the risk of complications and death during the perioperative period; this systematic review aims to assess the selection of anesthetic methods and medications used in upper limb surgeries for elderly patients. By compiling and analyzing data from existing published research, the review seeks to clarify the relative effectiveness, safety, and potential outcomes of various anesthesia techniques used in older individuals undergoing surgeries on the upper extremities. Methods Our study employed a systematic review methodology following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The study evaluated anesthesia techniques and drugs for upper limb surgery in older adults. Articles were identified through WEB of SCIENCE, MEDLINE, PUBMED, CINAHL searches, and Hand-Searching from January 2000 to January 2024, with eligibility criteria targeting studies on anesthesia for upper extremity surgeries only in older adults ≥ 65 years. Data extraction included study characteristics and outcomes related to anesthesia techniques and drugs. The methodological quality of included studies was assessed using the Cochrane risk-of-bias tool for randomized trials and the ROBINS-I tool for non-randomized studies of interventions. Results 18 articles met the inclusion criteria for the systematic review. The effectiveness of regional anesthesia is influenced by several factors. The addition of upper-extremity peripheral nerve blocks to general anesthesia during total shoulder arthroplasty has been shown not to increase the risk of complications or resource utilization. In arteriovenous fistula surgery, the application of a brachial plexus block for anesthesia has been shown to increase tissue oxygenation, as indicated by Near-Infrared Spectroscopy. Rotator cuff surgery pain management now favors continuous supraclavicular block, offering comparable pain relief to interscalene block but with fewer side effects Conclusion The review emphasizes the significance of selecting appropriate anesthesia techniques and drugs for upper limb surgery in elderly patients to enhance surgical outcomes and reduce perioperative complications.

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Section: Discussionmentioning

confidence: 99%

The Effects of Anesthesia Methods on the Prognosis of Elderly Patients Undergoing Upper Limb Surgery: A Systematic Review

Yin,

Wally,

OLAGUNJU

et al. 2024

Preprint

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Effect of Different Methods of Anesthesia on Surgically Created Arteriovenous Fistula

Koyš,

Drobná,

Drobná

2023

Obŝaâ reanimatologiâ

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Aim of the study was to determine the advantages of peripheral nerve blocks (PNB) versus local infiltration anesthesia (LIA) in the formation of arteriovenous fistula (AVF) surgically created for hemodialysis treatment Type of study: prospective non-randomized study. Approved by the ethics committee of JLF UK in Martin.Type of workplace: clinical workplace of a university hospital. Material and method. The cohort of patients (n=40) who required arteriovenous fistula (AVF) creation was divided into 2 groups, 20 patients each: patients operated under peripheral nerve blockade and patients operated under local infiltration anesthesia. The preserved function of the fistula was monitored 24 hours, 6 weeks and one year after the operation, without revision. Patient inclusion criteria included: age 19-75 years, ASA 3-4, weight 40-120kg, BMI up to 40. Statistical treatment of data included Mann-Whitney exact test, Fisher's test, t-test, ShapiroWilk normality test. Results. After 24 hours, all fistulas created with peripheral nerve blockade were functional whereas only 90% developed under local infiltration anesthesia remained functional (P>0.05 between groups). However, after 6 weeks, 80% of fistulas created under peripheral nerve block were functional, compared to 50% of functional fistulas created in patients under local infiltration anesthesia. (p=0.048). One year after surgery, the difference became a trend since 55% of fistulas created in peripheral nerve block remained functional while only 35% of fistulas created in patients receiving local infiltration anesthesia were functional without complications (p=0.097). Conclusion. In our study, the peripheral nerve block anestesia seem superior in term of better created fistula survival compared to local infiltration anesthesia.

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Could anaesthetic technique be blocking successful outcomes in arteriovenous fistula surgery?

Cited by 2 publications

References 27 publications

The Effects of Anesthesia Methods on the Prognosis of Elderly Patients Undergoing Upper Limb Surgery: A Systematic Review

The Effects of Anesthesia Methods on the Prognosis of Elderly Patients Undergoing Upper Limb Surgery: A Systematic Review

Effect of Different Methods of Anesthesia on Surgically Created Arteriovenous Fistula

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