• Nicola Pirozzi, Laura Pettorini, Jacopo Scrivano, Anna Giuliani, Matteo Baldinelli, Giorgio Punzo, Vincenzo Pirozzi, and Paolo Menè.
• Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy. n.pirozzi@tiscali.it
• J Vasc Access. 2012 Jul 1;13(3):296-8.

PurposeLoco-regional anesthesia, along with the neurosensitive inhibition causes arterial and venous vasodilatation, that could be of interest for vascular access surgery. We evaluated the long term vasoplegia persistence after brachial plexic block.MethodsFive patients submitted to brachial plexus block for an orthopedic procedure have been observed. Both radial arteries, that of the blocked arm and the opposite as a control, were analyzed by ultrasound examination, at time 0 and 360 minutes after anesthesia induction. All patients were treated with the same anesthesiologic protocol: axillary approach, use of an electroneurostimulator, injection 10 ml of ropivacain 7.5% + 10 ml of mepivacain 2%. The parameters evaluated from the arterial ultrasound flowmetry were: peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI).ResultsNo modification of the arterial flow were observed in the control arm at 0 and 360'after block induction. The blocked arm instead showed a significant decrease of the resistive index, stable at 360 minutes.ConclusionsThe vasoplegia accompaning plexic block lasted 6 hours after anesthesia induction. Whereas this longstanding haemodynamic effect is beneficial for early patency of vascular access for hemodialysis, needs to be ascertained by further investigations.

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