Local Anaesthesia vs Regional Block for Arteriovenous Fistulae
End Stage Renal Disease
About this trial
This is an interventional treatment trial for End Stage Renal Disease focused on measuring end stage renal disease, vascular access, regional anaesthesia
Eligibility Criteria
Inclusion Criteria:
- English-speaking
- Adult patients >18 years old
- Competent to give consent
- Scheduled for primary AVF formation at either radial or brachial artery.
Exclusion Criteria:
- Allergy to local anaesthetic.
- Coagulopathy
- Infection at the anaesthetic or surgical site.
- Patient preference for general or alternative anaesthesia
- Significant peripheral neuropathy or neurologic disorder affecting the upper extremity
- Pregnancy
- Previous AVF creation
- Known cephalic vein occlusion, central vein stenosis, brachial or radial artery stenosis
- Vein or artery less than 1.8mm, as measured by ultrasound
Sites / Locations
- Department of Renal Surgery, Western InfirmaryRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Local anaesthetic
Regional anaesthetic
Infiltration of local anaesthetic into the surgical site by the surgeon using a combination of 0.5% L-bupivicaine prior to incision and 1% lignocaine topically after the wound is opened. Maximum dose limits of 2mg/kg for bupivicaine, and 3mg/kg for lignocaine will be observed, recognising that these are additive.
Ultrasound guided brachial plexus block. Supraclavicular will be the block performed unless there is a contraindication in which case axillary block may be used. A 1:1 mixture of 0.5% L-bupivicaine and 1.5% lignocaine with adrenaline (1 in 200,000) will be injected, up to a volume of 40ml but using a minimum of 25ml. Maximum dose limits of 2mg for bupivicaine and 7mg/kg for lignocaine with adrenaline will be observed, recognising that these are additive.