Stellate Ganglion Block for Preserving Arteriovenous Fistula in Hemodialysis Patients Undergoing Major Lower Limb Orthopedic Surgery: a Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- Fistula flow rate
研究概览
简要总结
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.
详细描述
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
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 21 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age 21 to 75 years.
- •Both sexes.
- •American Society of Anesthesiologists (ASA) physical status III.
- •Chronic renal failure (CRF) patients.
- •Undergoing major lower limb orthopedic surgery.
排除标准
- •Psychiatric disorders.
- •History of substance abuse.
- •Ipsilateral brachial and radial artery stenosis.
- •Allergy to local anesthetics.
- •Cardiovascular and respiratory disorders.
- •Coagulopathy.
- •Use of vasoactive medications.
- •Obesity (body mass index >30 kg/m2).
研究组 & 干预措施
Stellate ganglion blockade
Patient will receive preemptive stellate ganglion blockade (SGB) just before spinal anesthesia.
干预措施: Stellate ganglion block (Drug)
结局指标
主要结局
Fistula flow rate
时间窗: 7th day postoperatively
Flow rate will be measured on the first day postoperative then on the 7th day.
次要结局
- Peak systolic velocity (PSV)(7th day postoperatively)
- Adverse effects(7th day postoperatively)
- End diastolic velocity (EDV)(7th day postoperatively)
- Incidence of failure(7th day postoperatively)
研究者
Ayman Mohamady Eldemrdash
Lecturer of Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine, Aswan University, Egypt
Aswan University