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Comparison of Sedoanalgesia Versus Ultrasound-Guided Supraclavicular Brachial Plexus Block for the Prevention of the Pain During Endovascular Treatment of Dysfunctional Hemodialysis Fistulas

  • Clinical Investigation
  • Venous Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

Although intravenous sedation and analgesia have been widely used as a first choice to relieve pain during treatment of dysfunctional hemodialysis fistulas by interventional radiology, the sedoanalgesic drugs have a considerable risk of respiratory depression, especially in hemodialysis patients. In this study, we compared the utility and efficiency of ultrasound-guided supraclavicular brachial plexus block versus sedoanalgesia for the prevention of pain during endovascular treatment of dysfunctional hemodialysis fistulas

Materials and Methods

Patients were randomized into two groups: ultrasound-guided supraclavicular brachial plexus block (n = 34) or sedoanalgesia group (n = 34). A visual analogue scale from no pain (= 0) to worst pain possible (= 10) was used to assess the pain intensity. Patient and operator satisfaction were graded from 0 to 2: 0, not satisfied at all; 1, partially satisfied; 2, satisfied (very well or complete satisfaction). Both groups were compared in terms of pain scores, patient and operator satisfaction as well as complications.

Results

The median pain score was significantly lower in the block group compared to the sedoanalgesia group, 0 (0–4) versus 6 (2–10), p = 0.0001. Patient satisfaction and operator satisfaction were significantly higher in the block group than in the sedoanalgesia group (p = 0.0001). Severe oxygen desaturation occurred in five (14.7%) patients following the administration of sedoanalgesia. No side effects or complications related to block procedure occurred in any patient.

Conclusion

Ultrasound-guided supraclavicular brachial plexus block has advantages over the sedoanalgesia during endovascular treatment of dysfunctional hemodialysis fistulas. It can provide safe and efficient analgesia with excellent procedural satisfaction in adult hemodialysis patients.

Level of Evidence

Level 1 (randomized controlled trial).

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References

  1. Skehan SJ, Malone DE, Buckley N, et al. Sedation and analgesia in adult patients: evaluation of a staged-dose system based on body weight for use in abdominal interventional radiology. Radiology. 2000;216:653–9.

    Article  CAS  PubMed  Google Scholar 

  2. Martin ML, Lennox PH. Sedation and analgesia in the interventional radiology department. J Vasc Interv Radiol. 2003;14:1119–28.

    Article  PubMed  Google Scholar 

  3. Johnson S. Sedation and analgesia in the performance of interventional procedures. Semin Intervent Radiol. 2010;27:368–73.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Beathard GA, Urbanes A, Litchfield T, Weinstein A. The risk of sedation/analgesia in hemodialysis patients undergoing interventional procedures. Semin Dial. 2011;24:97–103.

    Article  PubMed  Google Scholar 

  5. Mouquet C, Bitker MO, Bailliart O, et al. Anesthesia for creation of a forearm fistula in patients with end stage renal failure. Anesthesiology. 1989;70:909–14.

    Article  CAS  PubMed  Google Scholar 

  6. Laskowski IA, Muhs B, Rockman CR, et al. Regional nerve block allows for optimization of planning in the creation of arteriovenous access for hemodialysis by improving superficial venous dilatation. Ann Vasc Surg. 2007;21:730–3.

    Article  CAS  PubMed  Google Scholar 

  7. Malinzak EB, Gan TJ. Regional anesthesia for vascular access surgery. Anesth Analg. 2009;109:976–80.

    Article  PubMed  Google Scholar 

  8. Mulroy MF, McDonald SB. Regional anesthesia for outpatient surgery. Anesthesiol Clin N Am. 2003;21:289–303.

    Article  Google Scholar 

  9. Liu SS, Strodtbeck WM, Richman JM, Wu CL. A comparison of regional versus general anesthesia for ambulatory anesthesia: a meta-analysis of randomized controlled trials. Anesth Analg. 2005;101:1634–42.

    Article  PubMed  Google Scholar 

  10. Neuman MD, Silber JH, Elkassabany NM, Ludwig JM, Fleisher LA. Comparative effectiveness of regional versus general anesthesia for hip fracture surgery in adults. Anesthesiology. 2012;117:72–92.

    Article  CAS  PubMed  Google Scholar 

  11. Gedikoglu M, Andic C, Evren Eker H, Guzelmansur I, Oguzkurt L. Ultrasound-guided supraclavicular brachial plexus block for analgesia during endovascular treatment of dysfunctional hemodialysis fistulas. J Vasc Interv Radiol. 2014;25:1427–32.

    Article  PubMed  Google Scholar 

  12. Chiba E, Hamamoto K, Nagashima M, et al. Efficacy of ultrasound-guided axillary brachial plexus block for analgesia during percutaneous transluminal angioplasty for dialysis access. Cardiovasc Intervent Radiol. 2016;39:1407–12.

    Article  PubMed  Google Scholar 

  13. Hull J, Heath J, Bishop W. Supraclavicular brachial plexus block for arteriovenous hemodialysis access procedures. J Vasc Interv Radiol. 2016;27:749–52.

    Article  PubMed  Google Scholar 

  14. Gray RJ, Sacks D, Martin LG, Trerotola SO, The Members of the Society of Interventional Radiology Technology Assessment Committee. Reporting standards for percutaneous interventions in dialysis access. J Vasc Interv Radiol. 2003;14:S433–442.

    Article  PubMed  Google Scholar 

  15. Filippiadis DK, Binkert C, Pellerin O, et al. Cirse quality assurance document and standards for classification of complications: the Cirse classification system. Cardiovasc Intervent Radiol. 2017;40:1141–6.

    Article  CAS  PubMed  Google Scholar 

  16. Neal JM, Gerancher JC, Hebl JR, et al. Upper extremity regional anesthesia: essentials of our current understanding, 2008. Reg Anesth Pain Med. 2009;34:134–70.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Lanz E, Theiss D, Jankovic D. The extent of blockade following various techniques of brachial plexus block. Anesth Analg. 1983;62:55–8.

    CAS  PubMed  Google Scholar 

  18. Vermeylen K, Engelen S, Sermeus L, et al. Supraclavicular brachial plexus blocks: review and current practice. Acta Anaesthesiol Belg. 2012;63:15–211.

    CAS  PubMed  Google Scholar 

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Funding

This study was approved by Baskent University Institutional Review Board and Ethics Committee (Project No: KA 14/165) and supported by Baskent University Research Fund.

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Authors and Affiliations

  1. Department of Radiology, Baskent University School of Medicine, Dadaloglu Mah. 39. sok. No: 4/A, 01250, Yuregir/Adana, Turkey

    Murat Gedikoglu & Cagatay Andic

  2. Department of Anaesthesiology, Baskent University School of Medicine, Adana, Turkey

    Hatice Evren Eker

  3. Department of Radiology, City Hospital, Hatay, Turkey

    Ismail Guzelmansur

  4. Department of Radiology, Medline Hospital, Adana, Turkey

    Cagatay Bolgen

Authors
  1. Murat Gedikoglu
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  2. Cagatay Andic
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  3. Ismail Guzelmansur
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  4. Hatice Evren Eker
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  5. Cagatay Bolgen
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Corresponding author

Correspondence to Murat Gedikoglu.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Gedikoglu, M., Andic, C., Guzelmansur, I. et al. Comparison of Sedoanalgesia Versus Ultrasound-Guided Supraclavicular Brachial Plexus Block for the Prevention of the Pain During Endovascular Treatment of Dysfunctional Hemodialysis Fistulas. Cardiovasc Intervent Radiol 42, 1391–1397 (2019). https://doi.org/10.1007/s00270-019-02293-8

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  • DOI: https://doi.org/10.1007/s00270-019-02293-8

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