Abstract

SINGLE OR MULTIPLE-INJECTION TECHNIQUES FOR AXILLARY BRACHIAL PLEXUS BLOCK IN ARTERIOVENOUS FISTULA IMPLANTATION SURGERY: COMPARISON OF SUCCESS RATE AND COMPLICATIONS

Pooran Hajian*, Afshin Farhanchi and Mahshid Nikiousresht

Abstract

Background: Axillary brachial plexus block is a common and applicable method for regional anesthesia in various types of surgeries on upper extremities such as arteriovenous fistula implantation that successful blocking procedure of the nerves in this region produces a numb and limp arm that enables pain-free surgery. Objective: This study compared success rate and complications of single-injection and multiple-injection techniques for axillary brachial plexus blocking in candidate for arteriovenous fistula implantation surgery. Material/patients & Methods: Thirty four patients scheduled for arteriovenous fistula implantation were randomly assigned to singleinjection group (n=17) that only one nerve involved in surgical territory and multipleinjection group (n=17) that one nerve innervating the surgical site and other ones were stimulated at the axillary crease and the injection was fractionated in equal volumes for three nerves (10 ml lidocaine 1.5% was injected at each nerve). Results: The success rate of blocking was similar in both groups. the sensory blocking of ulnar never was successful in 70.6% and 94.0% (p = 0.575), sensory blocking of median never was successful in 88.2% and 70.6% (0.666), and sensory blocking of radial never was successful in 100% and 76.5% of patients in single-injection and multiple-injection groups (p = 0.779). Sensory analgesia lasted similarly in both group. Total procedure-related complication rate was 17.7% in singleinjection and 11.8% in multiple-injection group (p = 0.676). Conclusion: Single and multiple injection techniques were comparable in nerve blocking success rate and technique-related complications in patients who candidate for arteriovenous fistula implantation.

Keywords: brachial plexus block; arteriovenous fistula; surgery.