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Patient will receive preemptive stellate ganglion blockade (SGB) just before spinal anesthesia.

Patient will not receive preemptive stellate ganglion blockade (SGB).

Patient will receive preemptive stellate ganglion block (SGB) just before spinal anesthesia.

Stellate ganglion block

Ayman M Eldemrdash, MD

Soudy S Hammad, MD

Tarek S Hemaida, MD

Taha T Dardeer, MD

Ahmed A Mohsen, MD

Ahmed K Fathy, MD

Gamal H Shams, MD

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.

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

Stellate Ganglion Block for Preserving Arteriovenous Fistula in Hemodialysis Patients Undergoing Major Lower Limb Orthopedic Surgery

Stellate Ganglion Block for Preserving Arteriovenous Fistula in Hemodialysis Patients Undergoing Major Lower Limb Orthopedic Surgery: A Randomized Controlled Trial

The data will be available upon a reasonable request from the corresponding author after the end of study for one year.

Flow rate will be measured on the first day postoperative then on the 7th day.

Peak systolic velocity (PSV) will be measured from radial artery 2 cm. proximal to fistula site, on the first day postoperative then on the 7th day.

End diastolic velocity (EDV) will be measured from radial artery 2 cm. proximal to fistula site, on the first day postoperative then on the 7th day.

Incidence of failure will be measured on the first day postoperative then on the 7th day.

Postoperative adverse reactions such as hematoma, infection, thrombosis, bleeding, and pitosis will be recorded in both groups.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Stellate Ganglion Block for Preserving Arteriovenous Fistula in Hemodialysis Patients Undergoing Major Lower Limb Orthopedic Surgery	NCT06300658	Stellate Gangli... Arteriovenous F... Hemodialysis Major Lower Lim...	Stellate gangli...	21 Years - 75 Years	Aswan University
Stellate Ganglion Block for Preserving Arteriovenous Fistula in Hemodialysis Patients Undergoing Major Lower Limb Orthopedic Surgery	NCT06300658	Stellate Gangli... Arteriovenous F... Hemodialysis Major Lower Lim...	Stellate gangli...	21 Years - 75 Years	Aswan University

Spots Global Cancer Trial Database for major lower limb orthopedic surgery