Assessment of long-term vasoplegia induced by brachial plexus block: a favorable effect for hemodialysis angioaccess surgery?
Assessment of long-term vasoplegia induced by brachial plexus block: a favorable effect for hemodialysis angioaccess surgery?
J Vasc Access 2012; 13(3): 296 - 298
DOI:10.5301/jva.5000044
Authors
Nicola Pirozzi, Laura Pettorini, Jacopo Scrivano, Anna Giuliani, Matteo Baldinelli, Giorgio Punzo, Vincenzo Pirozzi, Paolo Menè
Abstract
Purpose: Loco-regional anesthesia, along with the neurosensitive inhibition causes arterial and venous vasodilatation, that could be of interest for vascular access surgery. We evaluated the long term vasoplegia persistence after brachial plexic block. Methods: Five patients submitted to brachial plexus block for an orthopedic procedure have been observed. Both radial arteries, that of the blocked arm and the opposite as a control, were analyzed by ultrasound examination, at time 0 and 360 minutes after anesthesia induction. All patients were treated with the same anesthesiologic protocol: axillary approach, use of an electroneurostimulator, injection 10 ml of ropivacain 7.5% + 10 ml of mepivacain 2%. The parameters evaluated from the arterial ultrasound flowmetry were: peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI).Results. No modification of the arterial flow were observed in the control arm at 0 and 360’after block induction. The blocked arm instead showed a significant decrease of the resistive index, stable at 360minutes. Conclusions: The vasoplegia accompaning plexic block lasted 6 hours after anesthesia induction. Whereas this longstanding haemodynamic effect is beneficial for early patency of vascular access for hemodialysis, needs to be ascertained by further investigations.
Article History
- • Accepted on 28/11/2011
- • Available online on 11/01/2012
- • Published in print on 28/09/2012
Article usage statistics
The blue line displays unique views in the time frame indicated.
The yellow line displays unique downloads.
Views and downloads are counted only once per session.
Authors
-
Pirozzi, Nicola [PubMed] [Google Scholar]
Department of Clinical and Molecular Medicine, Sapienza University, Rome - Italy
-
Pettorini, Laura [PubMed] [Google Scholar]
Department of Clinical and Molecular Medicine, Sapienza University, Rome - Italy
-
Scrivano, Jacopo [PubMed] [Google Scholar]
Department of Clinical and Molecular Medicine, Sapienza University, Rome - Italy
-
Giuliani, Anna [PubMed] [Google Scholar]
Department of Clinical and Molecular Medicine, Sapienza University, Rome - Italy
-
Baldinelli, Matteo [PubMed] [Google Scholar]
Department of Clinical Science, Sapienza University, Rome - Italy
-
Punzo, Giorgio [PubMed] [Google Scholar]
Department of Clinical and Molecular Medicine, Sapienza University, Rome - Italy
-
Pirozzi, Vincenzo [PubMed] [Google Scholar]
Department of Nephrology, Nuova ITOR, Rome - Italy
-
Menè, Paolo [PubMed] [Google Scholar]
Department of Clinical and Molecular Medicine, Sapienza University, Rome - Italy