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
Creators: name: Macfarlane, Alan
name: Kearns, Rachel J
name: Clancy, Marc James
name: Kingsmore, David
name: Stevenson, Karen
name: Jackson, Andrew
name: Mark, Patrick
name: Aitken, Margaret
name: Moonesinghe, Ramani
name: Vindrola-Padros, Cecilia
name: Gaianu, Lucian
name: Pettigrew, Gavin
name: Motallebzadeh, Reza
name: Karydis, Nikolaos
name: Vesey, Alex
name: Singh, Rita
name: Muniraju, Thalakunte
name: Suttie, Stuart
name: McConnachie, Alex
name: Wetherall, Kirsty
name: Hogg, Rosemary
name: Thomson, Iain
name: Nangalia, Vishal
name: Aitken, Emma
name: Group, The ACCess Collaborative
name: Lagaac, Regin
name: Hogg, Rosie
name: Dalton, Andrew
name: Bell, Samira
name: Ross, Rose
name: McNair, David
name: Stiff, Linda
name: Jardine, Catherine
name: Dosani, Mohammed Tariq
name: Sainsbury, Jennifer
name: Sran, Kiran
name: El-Boghdadly, Kariem
name: Castrillo, Nadia
name: Gilbert, James
name: Sinha, Sanjay
name: Sutherland, Sheera
name: Crosbie, Sarah
name: Gavrila, Madita
name: Montgomery, Sandra
name: McLennan, Tina
name: Tarkowska, Nina
name: Oliver, Scott
name: Brown, Liz
name: McLachlan, Shelley
name: Siqueira, Jonathan De
name: Troxler, Max
name: Dewhirst, Nikki
name: Wright, Mark
name: Srinath, Chetan
name: Bennett, Philip
name: Morrow, Darren
name: Clancy, Marc
name: Deelchand, Vashist
name: Badhan, Rani
name: Sivaprakasam, Rajesh
name: TimEgan, Gareth Ackland
name: Wikner, Matt
name: Macfarlane, Alan
name: Kearns, Rachel
name: MacConnachie, Alex
name: Moonsinghe, Ramani
name: Vindrola, Cecilia
Publisher: name: Apollo - University of Cambridge Repository
Year: 2021
Subjects: Anaesthesia
1506
1682
adult anaesthesia
end-stage renal failure
vascular surgery
transplant surgery

description: 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.