Inclusion Criteria:  Patient with end stage renal failure, dialysis dependent undergoing transposition of brachiocephalic fistula repair American Society of Anesthesiology Physical Status Classification System (ASA) II or III  Exclusion Criteria:  Patient refusal History or family history of malignant hyperthermia Known allergy to propofol or local anaesthetic agent Patients who have taken neuroleptics, benzodiazepine over 2 weeks within 1 month Chronic use of alcohols/ opioid Active lungs disease (eg. acute exacerbation of chronic obstructive pulmonary disease) Active and significant cardiac disease (eg. decompensated congestive cardiac failure, recent myocardial infarction) End-stage heart failure with left ventricular ejection fraction < 30% Recent (< 3 months) cerebrovascular accident