For patients who undergoing hemodialysis, it is important to have good AV fistula. One third of AV fistula usually fail during early stage. It is helpful to use nerve block to dilate the blood vessels and enhance the prognosis. But 0.2% Ropivacaine usually cause muscle weakness in present studies. The investigators hope to find the lowest concentration to provide sympathectomy without muscle weakness. Because the patients with hemodialysis usually have multiple co-morbidity, thus we choose patients with forearm fracture at the first place. With this result, the investigators can design further study for patients with hemodialysis. The investigators prefer proximal approach because brachial plexus run together in the cosctoclavicular space and show lower incidence of incomplete work.
Study Type
OBSERVATIONAL
Enrollment
66
Ultrasound-guided infraclavicular brachial plexus block
Change of diameter of basilic vein and brachial artery
Use ultrasound to measure the difference of diameter at different time point.
Time frame: Change from baseline diameter(pre-nerve block) at 45min
Change of diameter of basilic vein and brachial artery
Use ultrasound to measure the difference of diameter at different time point.
Time frame: Change from baseline diameter(pre-nerve block) at 24hour
Change of diameter of basilic vein and brachial artery
Use ultrasound to measure the difference of diameter at different time point.
Time frame: Change from baseline diameter(pre-nerve block) at 48hour
Sensory block of upper limb
A validated 3-point scale was used: 0 = no block (patient has normal sensation), 1 = patient can feel cold, but the sensation is reduced compared with the unblocked side, and 2 = complete anesthesia.
Time frame: 45min post nerve block
Sensory block of upper limb
A validated 3-point scale was used: 0 = no block (patient has normal sensation), 1 = patient can feel cold, but the sensation is reduced compared with the unblocked side, and 2 = complete anesthesia.
Time frame: 24hour post nerve block
Motor block of upper limb
A validated 3-point scale was used: 0 = no block (patient has normal power), 1 = patient can feel weakness with the unblocked side, and 2 = complete anesthesia.
Time frame: 45min post nerve block
Motor block of upper limb
A validated 3-point scale was used: 0 = no block (patient has normal power), 1 = patient can feel weakness with the unblocked side, and 2 = complete anesthesia.
Time frame: 24hour post nerve block
Motor block of upper limb
A validated 3-point scale was used: 0 = no block (patient has normal power), 1 = patient can feel weakness with the unblocked side, and 2 = complete anesthesia.
Time frame: 48hour post nerve block
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