Comparison of local, regional and general anaesthesia on surgical outcomes in arteriovenous fistula creation

Dialysis is essential for patients with end-stage renal disease and arteriovenous fistula (AVF) surgery creates access for high flow dialysis. This review examines the effects of local, regional and general anaesthesia on AVF outcomes, drawing on studies from 2014 to 2024. Regional anaesthesia is associated with improved primary patency and is often the preferred choice. While some studies suggest regional or local anaesthesia may improve maturation compared to general anaesthesia, findings are inconsistent. Despite higher upfront costs, regional anaesthesia may lead to better cost-effectiveness. All three modalities are considered safe and effective, though current evidence tends to favour regional anaesthesia. Further research is needed to clarify optimal anaesthetic strategies.