The aim of this study is to evaluate the role of stellate ganglion blockade (SGB) for preserving arteriovenous fistula in hemodialysis patients undergoing major lower limb orthopedic surgery.
The best way for dialysis in chronic renal failure (CRF) patients with consideration of feasibility, rate of infection, and patency is hemodialysis by using native access by using arteriovenous fistula (AVF). Altered calcium and phosphor metabolism in CRF patients would also increase vascular reactivity. Stellate ganglion blockade (SGB) has been used for several years for both diagnosis and treatment of circulatory problems in upper extremity. Recently preemptive SGB has been used in prevention of radial artery spasm in coronary artery patients. SGB increases blood flow and decrease vascular resistance in the arm. SGB prevents or ameliorates the reactivity of the muscular layer of the RA in response to both surgical manipulation during harvesting the artery and to the potent vasoconstrictor mediators released during surgery
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
50
Patient will receive preemptive stellate ganglion block (SGB) just before spinal anesthesia.
Aswan University
Aswān, Aswan Governorate, Egypt
RECRUITINGFistula flow rate
Flow rate will be measured on the first day postoperative then on the 7th day.
Time frame: 7th day postoperatively
Peak systolic velocity (PSV)
Peak systolic velocity (PSV) will be measured from radial artery 2 cm. proximal to fistula site, on the first day postoperative then on the 7th day.
Time frame: 7th day postoperatively
End diastolic velocity (EDV)
End diastolic velocity (EDV) will be measured from radial artery 2 cm. proximal to fistula site, on the first day postoperative then on the 7th day.
Time frame: 7th day postoperatively
Incidence of failure
Incidence of failure will be measured on the first day postoperative then on the 7th day.
Time frame: 7th day postoperatively
Adverse effects
Postoperative adverse reactions such as hematoma, infection, thrombosis, bleeding, and pitosis will be recorded in both groups.
Time frame: 7th day postoperatively
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