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Copyright (c) 2024 Rhendra Hardy Mohamad Zaini, Nurul Izzati Mohd Noor, Sanihah Che Omar, Praveena Seevaunnamtum Seevaunnamtum, Nurul ‘Aifaa Mohd Azmi
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Abstract
Background: Patients with end-stage renal failure (ESRF) who require arteriovenous fistula (AVF) creation often have multiple comorbidities, making the brachial plexus block a suitable choice for anaesthesia. The objective of this study is to compare the efficacy of ultrasound-guided supraclavicular and costoclavicular brachial plexus blocks for AVF creation.
Methods: A total of 70 patients scheduled for the creation of AVF in the distal upper extremity were randomly assigned to 2 groups: supraclavicular block (SCB), Group A: n = 35, and costoclavicular block (CCB), Group B: n = 35. Both groups received 20 ml of 0.5% ropivacaine and 10 ml of 1% lidocaine. The measured parameters included the speed of onset of motor and sensory blockade, the quality of blockade, procedural-related pain score, patient satisfaction, and regional perfusion.
Results: The costoclavicular block demonstrated a significantly faster onset to achieve complete paralysis (p = 0.01) in all sensory and motor nerves compared to the supraclavicular block. Additionally, there was a significant difference in regional perfusion, with higher perfusion observed in the supraclavicular block (p = 0.013). However, there were no significant differences in the quality of block (p = 0.573), and procedural-related pain score (p = 0.117) between the 2 groups.
Conclusion: The costoclavicular block offers a faster onset of sensory and motor blockade compared to the supraclavicular block. However, they are comparable in terms of the quality of the block and procedural-related pain. This new technique can be considered as an alternative for providing anaesthesia in patients with ESRF
undergoing AVF creation.
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