title: Axillary brachial plexus block duration with mepivacaine in patients with chronic renal failure. Case-control study.
abstract: BACKGROUND
  Regional anaesthesia is commonly preferred for arteriovenous fistula (AVF) creation. Previous studies suggest a shorter block duration in patients with chronic renal failure, maybe because of the changes in regional blood flow. The aim of our study was to evaluate the duration of the axillary block with 1.5% mepivacaine in patients with chronic renal failure scheduled for AVF compared with healthy controls.
  
  
  METHODS
  Patients scheduled for AVF creation for the first time (GIRC) were included. They were compared with patients without renal failure (GC), with similar anthropometric characteristics. Ultrasound-guided axillary blocks with 20mL of 1.5% mepivacaine were performed on all patients. We evaluated onset time, humeral artery diameter and blood flow before and after the block, as well as the block duration.
  
  
  RESULTS
  Twenty-three patients (GIRC: 12 and GC: 11) were included. No differences between groups were observed in block duration (GIRC: 227±43min vs GC: 229±27min; P=.781), or in onset time (GIRC: 13±5min vs GC: 12.2±3min; P=.477). The humeral blood flow before and after block was significantly lower in the GIRC (pre-block: GIRC: 52±21ml/min GC: 100±62ml/min; P=.034 and p ost block: GIRC: 130±57ml/min and GC: 274±182ml/min; P=.010). There was no significant correlation between the duration of the block and the preblock humeral blood flow (Spearman Rho: 0.106; P=.657) or the postblock humeral blood flow (Spearman Rho: 0.267; P=.254).
  
  
  CONCLUSIONS
  The duration of the axillary block with 1.5% mepivacaine in patients with chronic renal failure was similar to that of the control patients. The duration of axillary brachial plexus block seems not to be related to changes in regional blood flow.
authors.affiliation: Máster en Competencias Médicas Avanzadas, Facultad de Medicina, Universitat de Barcelona, Barcelona, España.
authors.forename: V
authors.initials: V
authors.lastname: Mojica
authors.affiliation: Máster en Competencias Médicas Avanzadas, Facultad de Medicina, Universitat de Barcelona, Barcelona, España.
authors.forename: D
authors.initials: D
authors.lastname: Nieuwveld
authors.affiliation: Máster en Competencias Médicas Avanzadas, Facultad de Medicina, Universitat de Barcelona, Barcelona, España.
authors.forename: A E
authors.initials: AE
authors.lastname: Herrera
authors.affiliation: Servicio de Cirugía Vascular, Hospital Clínic, Universitat de Barcelona, Barcelona, España.
authors.forename: G
authors.initials: G
authors.lastname: Mestres
authors.affiliation: Departamento de Anestesiología, Hospital Clínic, Universitat de Barcelona, Barcelona, España.
authors.forename: A M
authors.initials: AM
authors.lastname: López
authors.affiliation: Departamento de Anestesiología, Hospital Clínic, Universitat de Barcelona, Facultad de Medicina, Universitat de Barcelona, Barcelona, España. Electronic address: xsala@clinic.ub.es.
authors.forename: X
authors.initials: X
authors.lastname: Sala-Blanch
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage*; D001166:Arteriovenous Shunt, Surgical; D001365:Axilla; D065527:Brachial Plexus Block / Q000379:methods; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008619:Mepivacaine / Q000008:administration & dosage*; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D000779:Anesthetics, Local; D008619:Mepivacaine
keywords: Axilary block; Block duration; Bloqueo axilar; Chronic renal failure; Duración bloqueo axilar; Falla renal crónica; Mepivacaine; Mepivacaína