Comparison between ultrasound guided regional anaesthesia and general anaesthesia in arteriovenous fistula creation at the Douala General Hospital

Anaesthetic modalities for arteriovenous fistula (AVF) creation include general (GA), local (LA) and regional anaesthesia (RA). Ultrasound guided regional anaesthesia (USRA) proved to have more benefits in AVF creation than the other two. This study conducted at the Douala General Hospital aimed to assess these benefits over GA and RA. A retrospective review was performed on 217 records of patients who underwent an AVF creation between January 2015 and December 2018. The socio-demographic and clinical characteristics of patients were recorded. Analysis of variance, Pearson’s chi-square test and binomial logistic regression were performed and a p value of <0.05 was considered significant. Of the 217 records reviewed, age ranged between 51 and 60 years old, and 71.9% were males. The distribution of AVF according to the anaesthetic type was: 83 (38.2%) for GA, and 68 (31.3%) for USRA. The rate of changeover was significantly associated with the anaesthetic type [GA: null vs. USRA: 8 (11.8%), p < 0.001]. The total anaesthesia administration time and surgical time were significantly associated with the anaesthetic type. The association between the anaesthetic type and the complication was of no statistical importance. This study thus showed that USRA was superior to either GA in AVF creation. The surgical duration mitigated the time required for its performance as compared to GA. It was the most stable in term of cost of anaesthesia and yielded higher rates of functional patency 3 months after the fistulae were created.