title: Efficacy of Ultrasound-Guided Axillary Brachial Plexus Block for Analgesia During Percutaneous Transluminal Angioplasty for Dialysis Access.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of ultrasound (US)-guided axillary brachial plexus block (ABPB) for analgesia during percutaneous transluminal angioplasty (PTA) for dialysis access.
  
  
  METHODS
  Twenty-one patients who underwent PTA for stenotic dialysis access shunts and who had previous experience of PTA without sedation, analgesia, and anesthesia were included. The access type in all patients was native arteriovenous fistulae in the forearm. Two radiologists performed US-guided ABPB for the radial and musculocutaneous nerves before PTA. The patients' pain scores were evaluated using a visual analog scale (VAS) after PTA, and these were compared with previous sessions without US-guided ABPB. The patient's motor/sensory paralysis after PTA was also examined.
  
  
  RESULTS
  The mean time required to achieve US-guided ABPB was 8 min. The success rate of this procedure was 100 %, and there were no significant complications. All 21 patients reported lower VAS with US-guided ABPB as compared to without the block (p < 0.01). All patients expressed the desire for an ABPB for future PTA sessions, if required. Transient motor paralysis occurred in 8 patients, but resolved in all after 60 min.
  
  
  CONCLUSIONS
  US-guided ABPB is feasible and effective for analgesia in patients undergoing PTA for stenotic dialysis access sites.
  
  
  METHODS
  Level 4 (case series).
authors.affiliation: Department of Radiology, Saitama Medical Center, Jichi Medical University, 1-847 Amanumacho, Omiya, Saitama, 330-8503, Saitama, Japan. chibaemi23@comet.ocn.ne.jp.
authors.forename: Emiko
authors.identifier: http://orcid.org/0000-0002-5419-9946
authors.initials: E
authors.lastname: Chiba
authors.affiliation: Department of Radiology, Saitama Medical Center, Jichi Medical University, 1-847 Amanumacho, Omiya, Saitama, 330-8503, Saitama, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Hamamoto
authors.affiliation: Department of Emergency Medicine, Asahikawa Medical University, 1-1-1 Midorigaoka Higashi 2 Jo, Asahikawa, 078-8510, Hokkaido, Japan.
authors.forename: Michio
authors.initials: M
authors.lastname: Nagashima
authors.affiliation: Department of Radiology, Saitama Medical Center, Jichi Medical University, 1-847 Amanumacho, Omiya, Saitama, 330-8503, Saitama, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Matsuura
authors.affiliation: Department of Radiology, Saitama Medical Center, Jichi Medical University, 1-847 Amanumacho, Omiya, Saitama, 330-8503, Saitama, Japan.
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Okochi
authors.affiliation: Department of Radiology, Saitama Medical Center, Jichi Medical University, 1-847 Amanumacho, Omiya, Saitama, 330-8503, Saitama, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Tanno
authors.affiliation: Department of Radiology, Saitama Medical Center, Jichi Medical University, 1-847 Amanumacho, Omiya, Saitama, 330-8503, Saitama, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000698:Analgesia / Q000379:methods*; D017130:Angioplasty / Q000379:methods*; D001164:Arteriovenous Fistula / Q000628:therapy*; D001917:Brachial Plexus; D065527:Brachial Plexus Block / Q000379:methods*; D005260:Female; D005542:Forearm; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy; D011446:Prospective Studies; D006435:Renal Dialysis; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*
keywords: Hemodialysis; Percutaneous transluminal angioplasty; Ultrasound-guided axillary brachial plexus block