**5. Updated topic: comparison of anesthesia type for patency, complications, and economy**

Recently, the effect of anesthesia type on the patency of fistula, complications, and economy has been highlighted.

A previous retrospective study has reported that GA decreased early failure within 120 days after dialysis creation, while RA may decrease postoperative infection and bleeding [15]. On the other hand, a very recent study in 2022 did not show significant superiority of GA for fistula maturation [16].

The retrospective multivariable analysis has indicated that GA compared with RA/LA was independently associated with increased postoperative admission and decreased three months access utilization but similar 1-year access occlusion and intervention of which subgroup analysis of the RA/LA cohort showed RA was associated with increased three months access utilization but had similar 1-year access occlusion compared to LA [17]. A systematic review and meta-analysis comparison between RA and LA has indicated the superiority of RA over LA in terms of primary patency of fistula, brachial artery diameter, and operation duration [18]. A prospective study of the research group of Scotland, United Kingdom has indicated that RA significantly improved both primary and functional AVF patency at one year and cost compared to LA [19].

*Anesthetic Management of Surgical Vascular Access for Hemodialysis DOI: http://dx.doi.org/10.5772/intechopen.109844*

The topic of "which anesthesia is the best" has not been concluded yet. Most of the previous studies were retrospective or some were prospective but not enough of the subjects to conclude. Very recently, the new protocol of randomized, prospective, largenumber study has been published [20]. The result of this study, which has not been opened yet as of November 2022, maybe promising and conclusive.
