Document Detail


Does preemptive stellate ganglion blockage increase the patency of radiocephalic arteriovenous fistula?
MedLine Citation:
PMID:  17118830     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Radio-cephalic arteriovenous fistulas (AVFs) have high early failure ratio. Increased sympathetic activity and spasm of radial artery during the surgery may responsible for early occlusion rate. DESIGN: Fifty patients were randomized to two groups (each containing 25 patients). Stellate Ganglion Blockade (SGB) was performed in Group 1. Another group was considered as control group (Group 2) to make statistical comparisons. All AVFs were performed under local anesthesia in both groups. RESULTS: Average fistula flow was 201.4+/-40.4 ml/min in Group 1 and 155.6+/-27.4 ml/min in Group 2 (p < 0.001). While average peak velocity of radial artery was 167.1+/-31.3 cm/sec in Group 1, it was 107.8+/-15.8 cm/sec in Group 2 (p < 0.001). Thrill was found in all Group 1 patients, but there was thrill only 13 of the Group 2 patients (p < 0.001). Mean maturation time was 41.4+/-6.8 days after surgery in Group 1 and 77.1+/-10.5 days in Group 2 (p < 0.001). Adequate vascular access was obtained 19 patients in Group 1 and 12 patients in Group 2 (p = 0.041). CONCLUSION: AVF occlusion rate is much more common in early postoperative period. Diminished sympathetic tonus by preemptive SGB not only increases early patency rate but also increases fistula maturation rate.
Authors:
Vedat Yildirim; Suat Doganci; Omer Yanarates; Mutlu Saglam; Erkan Kuralay; Ahmet Cosar; M Erdal Guzeldemi
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Scandinavian cardiovascular journal : SCJ     Volume:  40     ISSN:  1401-7431     ISO Abbreviation:  Scand. Cardiovasc. J.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-11-22     Completed Date:  2007-03-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9708377     Medline TA:  Scand Cardiovasc J     Country:  England    
Other Details:
Languages:  eng     Pagination:  380-4     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Gulhane Military Academy of Medicine, Ankara, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Arterial Occlusive Diseases / etiology,  prevention & control
Arteriovenous Shunt, Surgical / adverse effects*
Autonomic Nerve Block*
Blood Flow Velocity
Female
Follow-Up Studies
Humans
Male
Middle Aged
Radial Artery / innervation,  physiopathology*,  surgery*
Regional Blood Flow
Renal Dialysis / methods
Research Design
Spasm / etiology,  prevention & control
Stellate Ganglion*
Time Factors
Vascular Patency*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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