CardioVascular and Interventional Radiology

, Volume 39, Issue 10, pp 1407–1412

Efficacy of Ultrasound-Guided Axillary Brachial Plexus Block for Analgesia During Percutaneous Transluminal Angioplasty for Dialysis Access

  • Emiko Chiba
  • Kohei Hamamoto
  • Michio Nagashima
  • Katsuhiko Matsuura
  • Tomohisa Okochi
  • Keisuke Tanno
  • Osamu Tanaka
Clinical Investigation

Abstract

Purpose

To evaluate the efficacy and safety of ultrasound (US)-guided axillary brachial plexus block (ABPB) for analgesia during percutaneous transluminal angioplasty (PTA) for dialysis access.

Subjects and Methods

Twenty-one patients who underwent PTA for stenotic dialysis access shunts and who had previous experience of PTA without sedation, analgesia, and anesthesia were included. The access type in all patients was native arteriovenous fistulae in the forearm. Two radiologists performed US-guided ABPB for the radial and musculocutaneous nerves before PTA. The patients’ pain scores were evaluated using a visual analog scale (VAS) after PTA, and these were compared with previous sessions without US-guided ABPB. The patient’s motor/sensory paralysis after PTA was also examined.

Results

The mean time required to achieve US-guided ABPB was 8 min. The success rate of this procedure was 100 %, and there were no significant complications. All 21 patients reported lower VAS with US-guided ABPB as compared to without the block (p < 0.01). All patients expressed the desire for an ABPB for future PTA sessions, if required. Transient motor paralysis occurred in 8 patients, but resolved in all after 60 min.

Conclusion

US-guided ABPB is feasible and effective for analgesia in patients undergoing PTA for stenotic dialysis access sites.

Level of Evidence

Level 4 (case series).

Keywords

Hemodialysis Percutaneous transluminal angioplasty Ultrasound-guided axillary brachial plexus block 

Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2016

Authors and Affiliations

  1. 1.Department of Radiology, Saitama Medical CenterJichi Medical UniversitySaitamaJapan
  2. 2.Department of Emergency MedicineAsahikawa Medical UniversityAsahikawaJapan

Personalised recommendations