General anesthesia is associated with reduced early failure among patients undergoing hemodialysis access

Journal of Vascular Surgery
Robert J BeaulieuMahmoud B Malas

Abstract

Despite recent reports of improved patency with regional anesthesia (RA), general anesthesia (GA) remains the most common choice for anesthesia for patients undergoing arteriovenous fistula (AVF) or arteriovenous graft (AVG) creation, with nearly 85% utilization. Previous studies of the effect of anesthesia type on outcomes have been conducted through single institutions or a national database with poor granularity for vascular-specific data. Given the high variability of practice patterns and the high prevalence of end-stage renal disease requiring access creation, further study of the impact of anesthesia choice during AVF or AVG creation is warranted. The Vascular Quality Initiative hemodialysis data set was queried to identify patients undergoing AVF or AVG creation between 2011 and 2017. Patients were grouped according to access type and anesthesia method (GA vs local anesthesia/RA). The primary outcome was early access failure within 120 days. Secondary outcomes were in-hospital and 30-day complications, including steal, swelling, hemorrhage, and wound infection. There were 31,028 patients undergoing AVG (6961) or AVF (24,067) identified. Compared with patients with GA, patients undergoing access creation with RA had high...Continue Reading

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Sep 25, 2018·Journal of Vascular Surgery·Isibor J ArhuideseMahmoud Malas

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Citations

Aug 16, 2019·Current Opinion in Anaesthesiology·Alan J R MacfarlaneNabil Elkassabany
Nov 15, 2020·British Journal of Anaesthesia·Alan J R MacfarlaneEmma Aitken
Jul 24, 2021·Journal of Vascular Surgery·Isibor J ArhuideseMahmoud B Malas
Sep 22, 2021·The Journal of Vascular Access·Kaitlin WoodsHeather K Hayanga

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