Hello there,

Is it possible to have an AV fistula inserted without a general anesthesic - obviously if this is possible, some other form of anesthesia would be needed - what would that be?

The patient in question suffered renal failure following a heart attack due to narrowed arteries leading to the heart - he was resuscitated, and has suffered some brain damage - although the prognosis in this regard is guardedly optimistic.

He is also a diabetic, is in his late 60s, and has started dialysis. Unfortunately, he is a bit confused, and continues to pull out the neck catheter needed for the dialysis.

The hospital have said that an AV fistula is what he needs, but are very reluctant to do it because the procedure requires a general anesthesic.

Surely, there is another way...I would appreciate any help anyone can offer. Many thanks for the opportunity to post to this board.



[This message has been edited by Jen (edited 01-17-2001).]

When I had my fistula done, they used a "sleeper" of valium injection, and then a "nerve blocker" at the shoulder to anestehtise my arm for the operation. Sorry for the lack of technical language, have'nt finished my coffee yet this morning. My surgeon, Dr. Unger, Miami Beach, a real artist.

I agree with m micone, I had mine placed with concious sedation and a block.
My concern is the patient is in his late 60's, has CAD, DM, ESRF and has suffered full cardiac arrest with brain damage and confusion. Any body every considered quality of life over quantity? I have promised my doctor to come back to haunt him if he does this to me (and I am only 39!)

Had fistula created in right upper arm (incision from armpit to elbow and acrossed) recently. I had general anesthesia. I had an experienced vascular surgeon. The surgery was same-day but took over three hours. I was unale to have fistula in forearm which would have been much less difficult, and would not have required general because vein and artery not as deep into arm. Arm was mapped and marked before procedure. Surgeon said he would have to "fish around" to make connection!