Efficacy and Safety of Ultrasound-Guided Supraclavicular Brachial Plexus Block during Angioplasty of Dysfunctional Arteriovenous Access: A Prospective, Randomized Single-Center Clinical Trial

Abstract

PURPOSE: To evaluate the efficacy and safety of the ultrasound-guided supraclavicular brachial plexus block (BPB) during angioplasty of dysfunctional arteriovenous access. <br>MATERIALS AND METHODS: Eighty study participants with dysfunctional arteriovenous access were enrolled in this prospective, randomized clinical trial between November 2016 and February 2018. Eighty patients were randomized to either the ultrasound-guided supraclavicular BPB group (mean age +/- standard deviation [SD], 65.1 +/- 12.4; male:female = 17:23) or the no regional anesthesia group (mean age +/- SD, 64.0 +/- 11.7; male:female = 25:15). Pain was assessed on the 10-point Visual Analogue Scale. Participant satisfaction was examined. Six-month clinical follow-up was done to evaluate arteriovenous access patency and long-term complications. <br>RESULTS: The BPB group showed a lower average pain score than the control group (mean +/- SD, 0.9 +/- 1.9 vs 6.4 +/- 2.5; P &lt; .001). Participant satisfaction (mean +/- SD, 2.8 +/- 0.5 vs 2.1+/-0.8; P &lt; .001) was also higher in the BPB group. Six-month patency was 65% (26/40) in the BPB group and 59% (23/39) in the control group, with no significant difference between the 2 groups (P = .59). No major immediate or delayed complications were observed. <br>CONCLUSIONS: Ultrasound-guided BPB is highly effective in reducing pain during angioplasty of dysfunctional arteriovenous access with an acceptable safety profile.