Ultrasound-guided axillary brachial plexus block in patients with chronic renal failure: report of sixteen cases.

In this report, 16 patients with end-stage renal disease undergoing forearm arteriovenous shunt surgery were subjected to an ultrasound-guided axillary approach for brachial plexus nerve block. Two doses of 15 ml lidocaine 1.5% were injected using a double-shot technique The spread of the solution within the plexus sheath could be visualized using a high-resolution 12-MHz imaging probe. Most patients (94%) experienced an excellent analgesia in the regions innervated by median, ulnar and radial nerves with a lower percentage of complete analgesia (63%) in the areas innervated by musculocutaneous nerve. Three patients, who complained of pain during the surgery required further supplements of narcotics. There were no complications such as, nerve injury, puncture of the axillary vessels or other systemic reactions. This technique provides adequate analgesia - without complications and without difficulty - for extremity surgery in patients with end-stage renal diseases.