Nerve block enhances the success rate in arterio-venous shunt operation in patients of chronic renal failure

Abstract

the aim of this study is to compare two anesthetic modalities commonly used for shunt creation surgery in the patients of end-stage renal disease, two common anesthetic modalities are compared in this study as regard suitability and enhancement of outcomes on short and long time ,the two methods were sonographic guided supraclavicular nerve block using bupivacaine local anesthetic, or local infiltration of bupivacaine at the surgical site, follow-up of 20 patients from each group revealed that nerve block not only was more comfortable for both patient and surgeon but also it enhanced the blood flow across the shunt detected by duplex scan performed 4 hours post-operative (p-value 0.002), also improves success rate of shunt detected by 4 months follow up, this may be explained by venous vasodilatation produced by sympathectomy that enhances blood flow at early hours and helps canalization of the shunt at the early hours of the shunt creation. Keywords: supraclavicular nerve block, shunt success, patient satisfaction SOHAG MEDICAL JOURNAL Nerve block enhances the success rate in arterio-venous shunt operation in patients