Abstract: 【Abstract】Objective To observe the efficacy of different anesthesia approaches for relieving pain during endovascular treatment of arteriovenous fistula in patients with end-stage renal disease so as to guide the rational choice of anesthesia methods for this operation. Method A total of 190 patients undergoing percutaneous transluminal balloon angioplasty (PTA) for arteriovenous fistulas at the Renal Department of Haidian Hospital from October 2019 to April 2020 were enrolled in this study and divided into three groups: control group (n=62), local infiltration anesthesia group (n=72) and selective nerve block group (n=56). After operation, Visual Analogue Scale (VAS) was used to evaluate the degree of pain during PTA and the satisfaction in patients and surgeons. The patients were followed up until December 2020 to observe patency of the fistulas. Result The median pain scores were 3 (0～8), 3 (0～10) and 7 (3～10) in selective nerve block group, local infiltration anesthesia group and control group respectively (F=42.656, P＜0.001). The satisfaction with pain management in patients and surgeons was significant different among the three groups (c2=42.656 and 33.859 respectively, P＜0.001). The primary patency rates after operation for 1, 3, 6 and 12 months were 98.1%, 81.8%, 54.5% and 32.7% respectively in selective nerve block group, 95.8%, 94.4%, 69.4% and 47.2% respectively in local infiltration anesthesia group, and 98.3%, 83.3%, 56.7% and 25.0% respectively in control group; the primary patency rates among the three groups were similar after the operation for one month (c2=0.907, P=0.736), 3 months (c2=5.603, P=0.065) and 6 months (c2=3.594, P=0.166), but were statistically different after the operation for 12 months (c2=7.355, P= 0.025). Conclusion Selective nerve block and local infiltration anesthesia approaches can provide effective and safe analgesia during endovascular treatment of arteriovenous fistulas with better patients’satisfaction and short-term primary patency rate.

Key words: Arteriovenous fistula, Hemodialysis, Percutaneous balloon angioplasty, Selective nerve block anesthesia, Local infiltration anesthesia