ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
A comparison of axillary blockage and local anesthesia techniques on autologous arteriovenous fistula flow rates and patient comfort in chronic hemodialysis patients
Mehmet Acıpayam1, Mustafa Hakan Zor2, Levent Altınay1, Hasan Uncu3, İnci Kara4, Ümit Halıcı5
1Mustafa Kemal Üniversitesi Tayfur Ata Sökmen Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Hatay, Türkiye
2Gazi Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahi Anabilim Dalı, Ankara, Türkiye
3Adana Numune Eğitim ve Araştırma Hastanesi, Seyhan Uygulama Hastanesi, Kalp ve Damar Cerrahi Kliniği, Adana, Türkiye
4Selçuk Üniversitesi Selçuklu Tıp Fakültesi, Anesteziyoloji ve Renimasyon Anabilim Dalı, Konya, Türkiye
5Samsun Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahi Kliniği, Samsun, Türkiye
DOI : 10.5606/tgkdc.dergisi.2013.6721
Background: In this article, we aim to compare the effects of axillary nerve block and local anesthesia techniques on the flow rate and patency of arteriovenous fistulas (AVF) and postoperative early-stage pain.

Methods: This prospective study included 30 patients who were scheduled for brachial artery-cephalic vein AVF construction operation between the dates June 2007 and August 2009. Group 1 (n=15) consisted of axillary nerve block, group 2 (n=15) consisted of local anesthesia administered patients. The mean age of group 1 and group 2 patients were 57.8±14.0 and 54.9±16.5 respectively. There were two patients with hypertension history in both groups. Pain scores were evaluated with visual analog scale (VAS) (0-10 cm) at 2, 6th and 24th hour after the operation. Arteriovenous fistulas patency and flow rates were measured by Doppler ultrasonography (USG) at 10th months during follow-up.

Results: Postoperative pain scores of 2, 6th and 24th hour in group 1 were 1.2±0.5, 2.8±0.7 and 1.9±0.4 respectively; the same values for group 2 were 3±1.3, 3±0.7 and 2±0.5 (p=0.000; p=0.480; p=0.497). The mean flow rates measured with Doppler USG after 10 months were 966.1±206.1 ml/min in group 1 and 871.6±338.3 ml/min in group 2 (p=0.513). All the AVF were patent in group 1 and group 2. Steal syndrome arised in three patients in group 2 and none in group 1 (p=0.68). There was one patient complicated with motor blockade on the same extremity, who spontaneously recovered after 24 hours in group 1.

Conclusion: We conclude that axillary blockage is an effective and safe technique in AVF construction operations which has also a positive long-term effect on AVF flow rates without any critical complication.

Keywords : Arteriovenous fistula; axillary blockade; visual analog scale
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