Effect of Brachial Plexus Block on Tissue Oxygenation in Arteriovenous Fistula Surgery: A Randomized Clinical Trial

Abstract

Objectives: Anesthesia methods have changed tissue blood flow. Near-infrared spectroscopy (NIRS) monitoring shows tissue oxygenation and indirectly blood flow. We aimed to investigate the effects of local infiltrative anesthesia and supraclavicular brachial plexus block on tissue oxygenation and fistula patency in arteriovenous fistula operations. Methods: Patients operated for arteriovenous fistula were divided into two groups. Group L (n=30) patients received 5% bupivacaine 15 ml local infiltrative anesthesia, while group B (n=30) patients received 0.5% bupivacaine 20 ml + 2% lidocaine 10 ml around the brachial plexus in the supraclavicular region. NIRS measurements of the patients were evaluated from the thenar region of both hands. Surgeon and patient satisfaction were evaluated with the Likert satisfaction rating scale. Patients were questioned for primary patency 1 month after the operation. Results: NIRS values of the arm with AV fistula were higher compared to values of other arm in group B and values of both arms in group L. Patient and surgeon satisfaction were higher in Group B. Primary fistula patency was similar between groups. Conclusion: In arteriovenous fistula surgery, tissue oxygenation measured by NIRS monitoring was higher in the extremity with brachial plexus block, but it did not have a positive effect on fistula patency evaluated at 1 month.