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< Vol. 15 Suppl. 7 | May 2014 | Presentations of the European Vascular Access Course 2014

Anesthesia for vascular access surgery

Anesthesia for vascular access surgery

J Vasc Access 2014; 15(Suppl. 7): 38 - 44

Article Type: ORIGINAL ARTICLE

Article Subject: EVC 2014

DOI:10.5301/jva.5000233

Authors

David Shemesh, Yefim Raikhinstein, Dina Orkin, Ilya Goldin, Oded Olsha

Abstract

The type of anesthesia chosen is an integral part of the decision-making process for arteriovenous access construction. We discuss the different types of anesthesia used, with emphasis on brachial plexus block, which is potentially safer than general anesthesia in this fragile patient population with end-stage renal disease. Brachial plexus block is superior to local anesthesia and enables the use of a tourniquet to minimize potential damage to the blood vessels during anastomosis using microsurgery techniques, and does not lead to the vasospasm that may be seen with local anesthesia. Regional anesthesia has a beneficial sympathectomy-like effect that causes vasodilation with increased blood flow during surgery and in the fistula postoperatively that may prevent early thrombosis and potentially improve outcome.

Article History

  • • Accepted on 13/02/2014
  • • Available online on 12/04/2014
  • • Published in print on 01/05/2014

Disclosures

Financial support: None.
Conflict of interest: None.

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Authors

  • Shemesh, David [PubMed] [Google Scholar] 1, * Corresponding Author (shemeshd@szmc.org.il)
  • Raikhinstein, Yefim [PubMed] [Google Scholar] 2
  • Orkin, Dina [PubMed] [Google Scholar] 3
  • Goldin, Ilya [PubMed] [Google Scholar] 1
  • Olsha, Oded [PubMed] [Google Scholar] 1

Affiliations

  • Department of Surgery and Hemodialysis Access Center, Shaare Zedek Medical Center, Jerusalem - Israel
  • Department of Anesthesiology, Shaare Zedek Medical Center, Jerusalem - Israel
  • Department of Anesthesiology, The Chaim Sheba Medical Center, Tel Hashomer - Israel

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