TITLE:
Practice of Ultrasound-Guided Axillary Block for the Creation of Arteriovenous Fistulas at the University Hospital Center of Libreville
AUTHORS:
Arsène Ifoudji Makao, Arthur Matsanga, Raphaël Okoue, Laurence Essola, Fernande Manga, Ingrid Abebo, Adrien Sima Zue
KEYWORDS:
Ultrasound-Guided Axillary Block, Arteriovenous Fistula, Libreville
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.16 No.3,
March
25,
2026
ABSTRACT: Introduction: The use of ultrasound has revolutionized the practice of regional anesthesia and expanded its indications to several specialties. Previously performed only through neurostimulation a few years ago in our context, the recent availability of ultrasound in the operating room has promoted the practice of ultrasound-guided axillary block by the new generation of anesthesiologists. Our objective was to evaluate the practice of ultrasound-guided axillary block in the creation of arteriovenous fistulas at the Libreville University Hospital Center (CHUL). Patients and Methods: A prospective study with a descriptive aim was conducted over a three-month period. Included were patients who were to undergo the creation of an arteriovenous fistula and who had given their prior consent for the performance of an ultrasound-guided axillary block. The parameters studied were sociodemographic data, comorbidities, the American Society of Anesthesiologists (ASA) classification, the type of approach, the arrangement of the different nerves, the technique of local anesthetic injection, the procedure time, the onset time of the anesthetic block, the duration of the anesthetic block, and any incidents. Results: Fifty patients were included, with a mean age of 54 ± 14.4 years. Hypertension and diabetes were the main comorbidities. The operator was experienced in 78% of the cases. The needle approach was in the plane of the ultrasound in all cases. The median nerve was the easiest target to approach. The injection of the local anesthetic was perineural in 86% of the cases. The average procedure time was 17.9 minutes, and the average duration of the sensory block was 208.5 minutes. The success rate was 94% for the median and musculocutaneous nerves and 92% for the radial and ulnar nerves. As incidents, five accidental venous punctures were noted. Conclusion: Ultrasound-guided axillary block is performed with a high success rate in the creation of arteriovenous fistulas. The anesthesia is of good quality, and complications are rare.