Target Audience

Southern Medical Journal (SMJ) is an interdisciplinary, multi-specialty Journal, and articles span the spectrum of medical topics, providing timely, up-to-date information for primary care physicians and specialists alike. The SMJ enables physicians to provide the best possible care to patients in this age of rapidly changing modern medicine.  Therefore, the readers of the SMJ are an appropriate target for this article.

Goals and Objectives

Patients with end-stage renal disease are at high risk for opioid exposure and use as a result of the need for multiple surgeries for hemodialysis access, as well as issues with underlying medical comorbidities and chronic pain. Regional anesthesia block is a viable option for vascular hemodialysis access surgeries as an alternative for general anesthesia.

Vascular access creation to perform hemodialysis is a common outpatient procedure that can be completed using general, regional, or local anesthetic techniques. There are few endorsed guidelines regarding opioid-based pain control following fistula creation. 

The purpose of this study was to determine whether utilization of regional anesthesia (RA) is associated with the decreased use of narcotics postoperatively. At the conclusion of the activity, learners should be better prepared to:

• Discuss anesthesia and perioperative analgesia options available to facilitate placement or modification of arterio-venous shunts for hemodialysis use.
• Develop clinical practices that allow local or regional anesthesia options for patients undergoing procedures to place or modify arterio-venous shunts to perform hemodialysis.
• Utilize peri-operative analgesia practices that successfully control pain and reduce medication risks in patients undergoing arterio-venous fistula placement or modification to allow hemodialysis.  

Course Information

CME Release Date: April 2, 2022
Valid for credit through:  April 1, 2025
Course type: Journal CME/CE
Estimated time of completion: 1 hour

Credits Available

Southern Medical Association is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Southern Medical Association designates this Journal CME/CE activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AAPA: AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. 

AANPCP: The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.

Healthcare Professionals
For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.  All healthcare professionals who are not MDs or DOs will receive a certificate of participation.

Instructions for Participation and Credit

This activity is designed to be completed within the time designated; learners should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period noted, following these steps:

• Read the goals and objectives, accreditation information, and author disclosures.
• Login in below to study the educational content and references.
• Complete the attestation, post-test (if applicable), and evaluation.

Upon successful completion of these components, your certificate will be processed and emailed from customerservice@sma.org within approximately 1 hour. Credits will be archived for 6 years; at any point within this time period you may login to your account to print a duplicate copy of your certificate.

Disclosure of Relevant Financial Relationships

Southern Medical Association (SMA) requires instructors, planners, managers, and all other individuals who are in a position to control the content of this activity to disclose conflicts of interest (COI) with ineligible entities within the last 24 months of the development of this activity. All identified COIs are thoroughly vetted and mitigated prior to the release of the activity. SMA is committed to providing its learners with high quality activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The following individuals, unless otherwise noted, have no relevant financial relationships to disclose.

Manuscript Author(s):
Amy Howk, MD
Callie McAdams, MD
Eric Heidel, PhD
Oscar Grandas, MD 

Southern Medical Association/Southern Medical Journal Editorial Staff:
Steven T. Baldwin, MD, SMJ Editor-in-Chief
Jennifer S. Price, MA, Managing Editor
Anita McCabe, Copyeditor