Anaesthesia Choice for Creation of Arteriovenous Fistula (ACCess) study protocol : a randomised controlled trial comparing primary unassisted patency at 1 year of primary arteriovenous fistulae created under regional compared to local anaesthesia. Issue 12 (22nd December 2021)

• Record Type: Journal Article
• Authors: Macfarlane, Alan JR; Kearns, Rachel J; Clancy, Marc James; Kingsmore, David; Stevenson, Karen; Jackson, Andrew; Mark, Patrick; Aitken, Margaret; Moonesinghe, Ramani; Vindrola-Padros, Cecilia; Gaianu, Lucian; Pettigrew, Gavin; Motallebzadeh, Reza; Karydis, Nikolaos; Vesey, Alex; Singh, Rita; Muniraju, Thalakunte; Suttie, Stuart; McConnachie, Alex; Wetherall, Kirsty; El-Boghdadly, Kariem; Hogg, Rosemary; Thomson, Iain; Nangalia, Vishal; Aitken, Emma
• Other Names: author non-byline.; Pettigrew Gavin author non-byline.; Lagaac Regin author non-byline.; Hogg Rosie author non-byline.; Suttie Stuart author non-byline.; Dalton Andrew author non-byline.; Bell Samira author non-byline.; Ross Rose author non-byline.; Muniraju Thalakunte author non-byline.; McNair David author non-byline.; Stiff Linda author non-byline.; Jardine Catherine author non-byline.; Singh Rita author non-byline.; Dosani Mohammed Tariq author non-byline.; Sainsbury Jennifer author non-byline.; Karydis Nikolaos author non-byline.; Sran Kiran author non-byline.; El-Boghdadly Kariem author non-byline.; Castrillo Nadia author non-byline.; Gilbert James author non-byline.; Sinha Sanjay author non-byline.; Sutherland Sheera author non-byline.; Crosbie Sarah author non-byline.; Gavrila Madita author non-byline.; Vesey Alex author non-byline.; Montgomery Sandra author non-byline.; McLennan Tina author non-byline.; Tarkowska Nina author non-byline.; Oliver Scott author non-byline.; Brown Liz author non-byline.; McLachlan Shelley author non-byline.; Siqueira Jonathan de author non-byline.; Troxler Max author non-byline.; Dewhirst Nikki author non-byline.; Wright Mark author non-byline.; Srinath Chetan author non-byline.; Bennett Philip author non-byline.; Morrow Darren author non-byline.; Aitken Emma author non-byline.; Clancy Marc author non-byline.; Thomson Iain author non-byline.; Jackson Andrew author non-byline.; Stevenson Karen author non-byline.; Kingsmore David author non-byline.; Aitken Margaret author non-byline.; Motallebzadeh Reza author non-byline.; Nangalia Vishal author non-byline.; Deelchand Vashist author non-byline.; Badhan Rani author non-byline.; Sivaprakasam Rajesh author non-byline.; TimEgan Gareth Ackland author non-byline.; Wikner Matt author non-byline.; Macfarlane Alan author non-byline.; Kearns Rachel author non-byline.; Gaianu Lucian author non-byline.; MacConnachie Alex author non-byline.; Wetherall Kirsty author non-byline.; Mark Patrick author non-byline.; Moonsinghe Ramani author non-byline.; Vindrola Cecilia author non-byline.;
• Is Part Of: BMJ open. Volume 11:Issue 12(2021)
• Publication Date: 2021-12-22
• Subjects: adult anaesthesia -- end-stage renal failure -- vascular surgery -- transplant surgery; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2021-052188
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Introduction: Arteriovenous fistulae (AVF) are the 'gold standard' vascular access for haemodialysis. Universal usage is limited, however, by a high early failure rate. Several small, single-centre studies have demonstrated better early patency rates for AVF created under regional anaesthesia (RA) compared with local anaesthesia (LA). The mechanistic hypothesis is that the sympathetic blockade associated with RA causes vasodilatation and increased blood flow through the new AVF. Despite this, considerable variation in practice exists in the UK. A high-quality, adequately powered, multicentre randomised controlled trial (RCT) is required to definitively inform practice. Methods and analysis: The Anaesthesia Choice for Creation of Arteriovenous Fistula (ACCess) study is a multicentre, observer-blinded RCT comparing primary radiocephalic/brachiocephalic AVF created under regional versus LA. The primary outcome is primary unassisted AVF patency at 1 year. Access-specific (eg, stenosis/thrombosis), patient-specific (including health-related quality of life) and safety secondary outcomes will be evaluated. Health economic analysis will also be undertaken. Ethics and dissemination: The ACCess study has been approved by the West of Scotland Research and ethics committee number 3 (20/WS/0178). Results will be published in open-access peer-reviewed journals within 12 months of completion of the trial. We will also present our findings at key national and international renal and anaesthetic meetings, and support dissemination of trial outcomes via renal patient groups. Trial registration number: ISRCTN14153938 . Sponsor: NHS Greater Glasgow and Clyde GN19RE456, Protocol V.1.3 (8 May 2021), REC/IRAS ID: 290482.