TY - JOUR T1 - 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 JF - BMJ Open JO - BMJ Open DO - 10.1136/bmjopen-2021-052188 VL - 11 IS - 12 SP - e052188 AU - Alan JR Macfarlane AU - Rachel J Kearns AU - Marc James Clancy AU - David Kingsmore AU - Karen Stevenson AU - Andrew Jackson AU - Patrick Mark AU - Margaret Aitken AU - Ramani Moonesinghe AU - Cecilia Vindrola-Padros AU - Lucian Gaianu AU - Gavin Pettigrew AU - Reza Motallebzadeh AU - Nikolaos Karydis AU - Alex Vesey AU - Rita Singh AU - Thalakunte Muniraju AU - Stuart Suttie AU - Alex McConnachie AU - Kirsty Wetherall AU - Kariem El-Boghdadly AU - Rosemary Hogg AU - Iain Thomson AU - Vishal Nangalia AU - Emma Aitken A2 - , Y1 - 2021/12/01 UR - http://bmjopen.bmj.com/content/11/12/e052188.abstract N2 - 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. ER -