Regional Anesthesia for Arteriovenous Fistula
Arteriovenous Fistula
About this trial
This is an interventional treatment trial for Arteriovenous Fistula
Eligibility Criteria
Inclusion Criteria:
- Patients with ESRD undergoing radio-cephalic AVF
Exclusion Criteria:
- Previous AVF procedures
- significant stenosis (>50% diameter reduction)
- calcifications of radial artery or cephalic vein
- radial artery diameter <1.6mm
- cephalic vein diameter <2.0mm
- history of pre-existing unilateral recurrent laryngeal nerve palsy
- pre-existing unilateral phrenic nerve palsy
- coagulopathy or pre-existing conditions that require anticoagulants or anti-platelet therapies
- history of IV drug use
- documented allergic reactions to local anesthetics
- pregnancy
- morbid obesity.
Sites / Locations
- St. Joseph's Healthcare Hamilton
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Active Comparator
Axillary Block with 0.5% Ropivicaine
Stellate Ganglion Block with 0.2% Ropivicaine
Local anesthetic infiltration with 0.25% Bupivicaine
Patients will receive an axillary block using an ultrasound-guided technique. After skin infiltration with 1 mL of 2% lidocaine, a 22-gauge insulated needle is advanced in-plane from the cephalic aspect of the transducer toward the posterior aspect of the axillary artery. Prior to injection, the syringe is aspirated to confirm extra-vascular placement of the needle. 20 mL solution of 0.5% ropivicaine is then injected slowly, with syringe aspiration after every 5 mL injection to confirm extravascular placement.
Patients will receive stellate ganglion block and local anesthetic using an ultrasound-guided technique.After skin infiltration with 1 mL of 2% lidocaine, a 22-gauge insulated needle is advanced in-plane from the lateral position toward the anterior aspect of longus colli muscle just posterior to the internal jugular vein. Prior to injection, the syringe is aspirated to confirm extra-vascular placement of the needle. 10 mL of 0.2% ropivicaine is then injected slowly, with syringe aspiration after every 5 mL injection to confirm extravascular placement.
Patients will receive local anesthetic infiltration of 0.25% Bupivicaine at the surgical site which will last approximately 6 hours.