Research Article | | Peer-Reviewed

Ultrasound-Guided Axillary Brachial Plexus Block in Patients with End-Stage Kidney Disease at Brazzaville University Teaching Hospital

Received: 2 October 2026     Accepted: 13 October 2026     Published: 29 October 2026
Views:       Downloads:
Abstract

Aim: to describe the anaesthetic management of patients with End-Stage Kidney Disease (ESKD) undergoing surgical procedures to create Arterio-Veinous Fistula (AVF) under ultrasound-guided Axillary Brachial Plexus Block (ABPB) in a campaign offering free AVF creation at Brazzaville University Teaching Hospital (CHUB). Patients and methods: The study was a descriptive, cross-sectional, single-centre study conducted from 1st to 18th July 2025 in the operating room at the CHUB. After obtaining their written consent, we had included patients with ESKD underwent AVF creation under ultrasound-guided ABPB in a free treatment programme. The variables socio-epidemiological, related to ESKD, related to haemodialysis, clinical, biological, therapeutic, related to ABPB and related to the AVF were studied Microsoft Excel 2021. Results: 40 patients were involved. The median age was 48 years [41-63 years]. The sex ratio was 3: 1, and 37.5% of patients had no source of income. ESKD had been diagnosed for a median of 6 months [3-12 months]. Haemodialysis (95%) was carried out using a femoral catheter (52.6%) and 80% of patients (n=32) had three sessions per week. Comorbidities (100%) were dominated by hypertension (97.5%). Long-term treatment (92.5%) combined an antihypertensive medication (97.3%) in a dual-therapy (41.7%) with amlodipine (69.2%). In anaesthesia consultation, an imbalance in arterial pressures (57.5%), a normal clinical examination (42.5%) and ASA 3 (100%) were predominant. The median duration of the ultrasound-guided ABPB was 11 minutes [10-12 minutes]. The procedure took between 11 and 15 minutes for 52.5% of patients. Bupivacaine 2 mg/ml (100%) was used with a median volume injected of 22 ml [20-25 ml] (range: 15-32 ml) and in 50% of cases, the volume injected was between 10 and 20 ml. The median time to onset of sensory block was 3 minutes [3-5 minutes] and in 87.5% of cases the time to onset was less than five minutes. Motor block was complete in all patients (100%). All ABPB procedures were ‘successful’ (100%). No intraoperative anaesthetic complications were recorded. The sensory block had a median duration of 250 minutes [217.5-280 minutes]. The AVFs were proximal (75%). The median duration of AVF surgery was 135 minutes [80-180 minutes] with 95% of success. All patients (100%) were transferred to POCU following surgery. Conclusion: Ultrasound-guided ABPB enabled the surgical creation of AVF in 40 patients with ESKD at the CHUB. The success rate for ABPB was 100% and that for AVF was 95%.

Published in International Journal of Anesthesia and Clinical Medicine (Volume 14, Issue 2)
DOI 10.11648/j.ijacm.20261402.17
Page(s) 173-180
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2026. Published by Science Publishing Group

Keywords

End-Stage Kidney Disease, Ultrasound-guided Axillary Brachial Plexus Block, Arteriovenous Fistula, Brazzaville

References
[1] Levey AS, Eckardt K-U, Dorman NM, Christiansen SL, Hoorn EJ, Ingelfinger JR. et al. Nomenclature for kidney function and disease: report of a kidney disease: Improving Global Outcomes (KDIGO) Consensus Conference. Kidney international. 2020; 97(6): 1117-29.
[2] Herrington WG, Judge PK, Grams ME, Wanner C. Chronic kidney disease. Lancet 2026; 407: 90-104.
[3] Nweke M, Ado-Aghughu T, Daniels T, Imo U. Burden and distribution of chronic kidney disease in sub-saharan africa: a systematic review with meta-analysis. Afr Health Sci 2025; 25(1): 373-394.
[4] Eyeni Sinomono DT, Loumingou R, Gassongo Koumou GC, Mahoungou GH, Mobengo JL. Chronic renal failure in the University Teaching Hospital of Brazzaville: epidemiology, clinical presentation and evolution. Health Sci. Dis 2021; 22 (1): 11-14.
[5] Saran S, Kharat A, Reddy GHV, Madhavan B, Bhattacharjee A, Thomas MP. Anaesthesia Challenges in Patients With Chronic Kidney Disease: A Clinical Approach From Internal Medicine. Cureus 2025; 17(9): e91694.
[6] Russu E, Munteanu A-C, Arbănasi E-M, Szanto L-A, Bartus R, Florea E, et al. Out-Patient versus In-Patient Arteriovenous Fistula Creation for Dialysis: Assessing Cost-Effectiveness Alongside Clinical Implications. Healthcare 2024; 12, 1102.
[7] Eyeni Sinomono DT, Malonga Beri RB, Gandzali Ngabe EP, Missamou A, Mahoungou GH, Moukengue Loumingou R, et al. Descriptive analysis of the population of chronic hemodialysis patients in Congo-Brazzaville. Health Sci. Dis 2021; 22 (5): 57-62.
[8] Bruessel P, Fryer D, Marfleet C, Klarissa T. Peri-Operative Surgical and Anaesthetic Predictors of Autogenous Arteriovenous Fistula (AVF) Maturation: A Retrospective Cohort Analysis. Vascular Health and Risk Management 2026: 22 591189.
[9] Li J, Karmakar MK, Li X, Kwok WH, Ngan Kee WD. Regional hemodynamic changes after an axillary brachial plexus block: A pulse-wave Doppler ultrasound study. Reg Anesth Pain Med, 37(1), 111-118.
[10] Elombila M, Niengo Outsouta G, MPoy Emy Monkessa CM, Bilongo-Bouyou AS, Okiemy Niendet CP, Bokoba-Nde Ngala MA, et al. Practice of ultrasound guided peripheral nerve blocks of brachial plexus at the teaching hospital of Brazzaville. Rev Afr Anesth Med Urg 2024; 29 (1): 12 - 18.
[11] Bernucci F, Gonzalez AP, Finlayson RJ, Tran DQ. A Prospective, Randomized Comparison Between Perivascular and Perineural Ultrasound-Guided Axillary Brachial Plexus Block. Reg Anesth Pain Med 2012; 37: 473-477.
[12] Ashuntantang G, Osafo C, Olowu WA, Arogundade F, Niang A, Porter J, et al. Outcomes in adults and children with end-stage kidney disease requiring dialysis in sub-Saharan Africa: a systematic review. Lancet Glob Health 2017; 17, 2017.
[13] Kazes I, Solignac J, Lassalle M, Mercadal L, Couchoud C. Twenty years of the French Renal Epidemiology and Information Network. Clinical Kidney Journal 2024; 17 (1): 1-12.
[14] Sleiman J, Soler Pujol G, Montañez E, Roatta V, Laham G. Access to treatment in chronic kidney disease, dialysis and transplantation. Is there gender equality? Front. Med. 2023; 10: 1176975.
[15] Niang A, Lemrabott AT. Global dialysis perspective: Senegal. Kidney360 2020; 1(6): 538-540.
[16] Samake M, Sy S, Yattara H, Eryam M, Diallo D, Coulibaly M, et al. Samaké M, Sy S, Yattara H, Eryam M, Diallo D, Coulibaly M, et al. Epidemiological and clinical aspects of chronic renal failure in the Nephrology and Haemodialysis Department at the Point G University Hospital, Bamako, Mali. Jaccr Africa 2022; 6(2): 158-165.
[17] Yirga GK, Aytenew TM, Kassaw A, Hiruy EG, Shiferaw K, Baye AA, et al. chronic kidney disease among patients with hypertension in sub-Saharan Africa: a systematic review and meta-analysis. BMC Public Health 2025; 25(1): 1603
[18] Yaxley J. Anaesthesia in chronic dialysis patients: A narrative review. World J Crit Care Med 2025; 14(1): 100503
[19] Zetlaoui P-J, Choquet O. Techniques d’anesthésie locorégionale du membre supérieur. EMC - Anesthésie-Réanimation 2013; 10(1): 1-28 [Article 36-321-A-10].
[20] Leye PA, Traoré MM, Bah MD, Ndiaye PI, Fall ML, Diop MN, et al. Evaluation of the practice of ultrasound-guided axillary brachial plexus block at a teaching Hospital in Dakar. Rev. Afr. Anesthésiol. Med. Urg. 2017; 22 (1): 53-57.
[21] Donamou J, Bah ML, Bangoura A. Locoregional anaesthesia in a country with limited resources: lidocaine 1.5% adrenaline, alternative to ropivacaine 0.5% for ultrasound-guided axillary block. Med Trop Sante Int 2021; 29; 1(1): EFX9-0P51.
[22] Matsanga A, Edjo Nkilly G, Ngomas JF, Obame R, Emery Sougou, Mandji L, et al. Étude Comparative du Bloc Axillaire par Neurostimulation Versus sous Échographie au Service d’Anesthésie-Réanimation du Centre Hospitalier Universitaire d’Owendo. Health. Sci. Dis. 2020; 21 (12): 6-9.
[23] Vastrad VV, Mulimani SM, Talikoti DG, Sorganvi VM. A comparative clinical study of ultrasonography-guided perivascular and perineural axillary brachial plexus block for upper limb surgeries. Anesth Essays Res 2019; 13: 163-8.
[24] Beloeil H, Mazoit J-X. Pharmacologie des anesthésiques locaux. EMC- Anesthésie-Réanimation, 2010; 36-320-A-10, 2010.
[25] Wilderman I, Sarzetto F, Wijetillake B, Verdun S. The Present and Future of Pain Management in Patients With Chronic Kidney Disease: A Narrative Review. Cureus 2025; 17(12): e100490.
[26] Takeda A, Ferraro LHC, Rezende AH, Sadatsune EJ, dos Reis Falcão LF, Tardelli MA. Minimum effective concentration of bupivacaine for axillary brachial plexus block guided by ultrasound. Rev Bras Anestesiol. 2015; 65(3): 163-169.
[27] Macfarlane AJR, Gitman M, Bornstein KJ, El-Boghdadly K, Weinberg G. Updates in our understanding of local anaesthetic systemic toxicity: a narrative review. Anaesthesia 2021; 76 (1): 27-39.
[28] Raphael KL. Metabolic Acidosis in CKD: Pathogenesis, Adverse Effects, and Treatment Effects. Int. J. Mol. Sci. 2024; 25(10): 5187.
Cite This Article
  • APA Style

    Gilles, N. O., Mayick, M. E. M. C., Honal, M. G., Reddy, A., Tony, E. S. D., et al. (2026). Ultrasound-Guided Axillary Brachial Plexus Block in Patients with End-Stage Kidney Disease at Brazzaville University Teaching Hospital. International Journal of Anesthesia and Clinical Medicine, 14(2), 173-180. https://doi.org/10.11648/j.ijacm.20261402.17

    Copy | Download

    ACS Style

    Gilles, N. O.; Mayick, M. E. M. C.; Honal, M. G.; Reddy, A.; Tony, E. S. D., et al. Ultrasound-Guided Axillary Brachial Plexus Block in Patients with End-Stage Kidney Disease at Brazzaville University Teaching Hospital. Int. J. Anesth. Clin. Med. 2026, 14(2), 173-180. doi: 10.11648/j.ijacm.20261402.17

    Copy | Download

    AMA Style

    Gilles NO, Mayick MEMC, Honal MG, Reddy A, Tony ESD, et al. Ultrasound-Guided Axillary Brachial Plexus Block in Patients with End-Stage Kidney Disease at Brazzaville University Teaching Hospital. Int J Anesth Clin Med. 2026;14(2):173-180. doi: 10.11648/j.ijacm.20261402.17

    Copy | Download

  • @article{10.11648/j.ijacm.20261402.17,
      author = {Niengo Outsouta Gilles and Mpoy Emy Monkessa Christ Mayick and Mahoungou Gael Honal and Atipo-Galloye Reddy and Eyeni Sinomono Daniel Tony and Bokoba Nde-Ngala Marina Aurole and Kibamba-Nieme Isaac Bravis and Moumpala Samuel Heberdent De Jacob and Elombila Marie and Otiobanda Gilbert Fabrice},
      title = {Ultrasound-Guided Axillary Brachial Plexus Block in Patients with End-Stage Kidney Disease at Brazzaville University Teaching Hospital},
      journal = {International Journal of Anesthesia and Clinical Medicine},
      volume = {14},
      number = {2},
      pages = {173-180},
      doi = {10.11648/j.ijacm.20261402.17},
      url = {https://doi.org/10.11648/j.ijacm.20261402.17},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20261402.17},
      abstract = {Aim: to describe the anaesthetic management of patients with End-Stage Kidney Disease (ESKD) undergoing surgical procedures to create Arterio-Veinous Fistula (AVF) under ultrasound-guided Axillary Brachial Plexus Block (ABPB) in a campaign offering free AVF creation at Brazzaville University Teaching Hospital (CHUB). Patients and methods: The study was a descriptive, cross-sectional, single-centre study conducted from 1st to 18th July 2025 in the operating room at the CHUB. After obtaining their written consent, we had included patients with ESKD underwent AVF creation under ultrasound-guided ABPB in a free treatment programme. The variables socio-epidemiological, related to ESKD, related to haemodialysis, clinical, biological, therapeutic, related to ABPB and related to the AVF were studied Microsoft Excel 2021. Results: 40 patients were involved. The median age was 48 years [41-63 years]. The sex ratio was 3: 1, and 37.5% of patients had no source of income. ESKD had been diagnosed for a median of 6 months [3-12 months]. Haemodialysis (95%) was carried out using a femoral catheter (52.6%) and 80% of patients (n=32) had three sessions per week. Comorbidities (100%) were dominated by hypertension (97.5%). Long-term treatment (92.5%) combined an antihypertensive medication (97.3%) in a dual-therapy (41.7%) with amlodipine (69.2%). In anaesthesia consultation, an imbalance in arterial pressures (57.5%), a normal clinical examination (42.5%) and ASA 3 (100%) were predominant. The median duration of the ultrasound-guided ABPB was 11 minutes [10-12 minutes]. The procedure took between 11 and 15 minutes for 52.5% of patients. Bupivacaine 2 mg/ml (100%) was used with a median volume injected of 22 ml [20-25 ml] (range: 15-32 ml) and in 50% of cases, the volume injected was between 10 and 20 ml. The median time to onset of sensory block was 3 minutes [3-5 minutes] and in 87.5% of cases the time to onset was less than five minutes. Motor block was complete in all patients (100%). All ABPB procedures were ‘successful’ (100%). No intraoperative anaesthetic complications were recorded. The sensory block had a median duration of 250 minutes [217.5-280 minutes]. The AVFs were proximal (75%). The median duration of AVF surgery was 135 minutes [80-180 minutes] with 95% of success. All patients (100%) were transferred to POCU following surgery. Conclusion: Ultrasound-guided ABPB enabled the surgical creation of AVF in 40 patients with ESKD at the CHUB. The success rate for ABPB was 100% and that for AVF was 95%.},
     year = {2026}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Ultrasound-Guided Axillary Brachial Plexus Block in Patients with End-Stage Kidney Disease at Brazzaville University Teaching Hospital
    AU  - Niengo Outsouta Gilles
    AU  - Mpoy Emy Monkessa Christ Mayick
    AU  - Mahoungou Gael Honal
    AU  - Atipo-Galloye Reddy
    AU  - Eyeni Sinomono Daniel Tony
    AU  - Bokoba Nde-Ngala Marina Aurole
    AU  - Kibamba-Nieme Isaac Bravis
    AU  - Moumpala Samuel Heberdent De Jacob
    AU  - Elombila Marie
    AU  - Otiobanda Gilbert Fabrice
    Y1  - 2026/10/29
    PY  - 2026
    N1  - https://doi.org/10.11648/j.ijacm.20261402.17
    DO  - 10.11648/j.ijacm.20261402.17
    T2  - International Journal of Anesthesia and Clinical Medicine
    JF  - International Journal of Anesthesia and Clinical Medicine
    JO  - International Journal of Anesthesia and Clinical Medicine
    SP  - 173
    EP  - 180
    PB  - Science Publishing Group
    SN  - 2997-2698
    UR  - https://doi.org/10.11648/j.ijacm.20261402.17
    AB  - Aim: to describe the anaesthetic management of patients with End-Stage Kidney Disease (ESKD) undergoing surgical procedures to create Arterio-Veinous Fistula (AVF) under ultrasound-guided Axillary Brachial Plexus Block (ABPB) in a campaign offering free AVF creation at Brazzaville University Teaching Hospital (CHUB). Patients and methods: The study was a descriptive, cross-sectional, single-centre study conducted from 1st to 18th July 2025 in the operating room at the CHUB. After obtaining their written consent, we had included patients with ESKD underwent AVF creation under ultrasound-guided ABPB in a free treatment programme. The variables socio-epidemiological, related to ESKD, related to haemodialysis, clinical, biological, therapeutic, related to ABPB and related to the AVF were studied Microsoft Excel 2021. Results: 40 patients were involved. The median age was 48 years [41-63 years]. The sex ratio was 3: 1, and 37.5% of patients had no source of income. ESKD had been diagnosed for a median of 6 months [3-12 months]. Haemodialysis (95%) was carried out using a femoral catheter (52.6%) and 80% of patients (n=32) had three sessions per week. Comorbidities (100%) were dominated by hypertension (97.5%). Long-term treatment (92.5%) combined an antihypertensive medication (97.3%) in a dual-therapy (41.7%) with amlodipine (69.2%). In anaesthesia consultation, an imbalance in arterial pressures (57.5%), a normal clinical examination (42.5%) and ASA 3 (100%) were predominant. The median duration of the ultrasound-guided ABPB was 11 minutes [10-12 minutes]. The procedure took between 11 and 15 minutes for 52.5% of patients. Bupivacaine 2 mg/ml (100%) was used with a median volume injected of 22 ml [20-25 ml] (range: 15-32 ml) and in 50% of cases, the volume injected was between 10 and 20 ml. The median time to onset of sensory block was 3 minutes [3-5 minutes] and in 87.5% of cases the time to onset was less than five minutes. Motor block was complete in all patients (100%). All ABPB procedures were ‘successful’ (100%). No intraoperative anaesthetic complications were recorded. The sensory block had a median duration of 250 minutes [217.5-280 minutes]. The AVFs were proximal (75%). The median duration of AVF surgery was 135 minutes [80-180 minutes] with 95% of success. All patients (100%) were transferred to POCU following surgery. Conclusion: Ultrasound-guided ABPB enabled the surgical creation of AVF in 40 patients with ESKD at the CHUB. The success rate for ABPB was 100% and that for AVF was 95%.
    VL  - 14
    IS  - 2
    ER  - 

    Copy | Download

Author Information
  • Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Republic of Congo;Department of Anaesthesia and Critical Care, Brazzaville University Teaching Hospital, Brazzaville, Republic of Congo

  • Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Republic of Congo;Department of Anaesthesia and Critical Care, Brazzaville University Teaching Hospital, Brazzaville, Republic of Congo

  • Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Republic of Congo;Centre of Chronic Kidney Disease Treatment, Ministry of Health and Population, Brazzaville, Republic of Congo

  • Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Republic of Congo;Department of Polyvalent Surgery, Cardiovascular and Thoracic Surgery Unit, Brazzaville University Hospital, Brazzaville, Republic of the Congo

  • Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Republic of Congo;Centre of Chronic Kidney Disease Treatment, Ministry of Health and Population, Brazzaville, Republic of Congo

  • Department of Anaesthesia and Critical Care, Brazzaville University Teaching Hospital, Brazzaville, Republic of Congo

  • Department of Anaesthesia and Critical Care, Brazzaville University Teaching Hospital, Brazzaville, Republic of Congo

  • Department of Polyvalent Surgery, Cardiovascular and Thoracic Surgery Unit, Brazzaville University Hospital, Brazzaville, Republic of the Congo

  • Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Republic of Congo;Department of Anaesthesia and Critical Care, Brazzaville University Teaching Hospital, Brazzaville, Republic of Congo

  • Faculty of Health Sciences, Marien Ngouabi University, Brazzaville, Republic of Congo;Department of Anaesthesia and Critical Care, Brazzaville University Teaching Hospital, Brazzaville, Republic of Congo

  • Sections