Trends in Clinical and Medical Sciences
Special issue: Recent developments of medical and surgical research (2023), pp. 210 – 216
ISSN: 2791-0814 (online) 2791-0806 (Print)
DOI: 10.30538/psrp-tmcs2023.si-rdmsr028
ISSN: 2791-0814 (online) 2791-0806 (Print)
DOI: 10.30538/psrp-tmcs2023.si-rdmsr028
A randomized and comparative study on anterior approach versus posterior approach for internal jugular vein cannulation
Rashmi Pal\(^1\), Aradhna Chourasiya\(^{2,*}\), K. K Arora\(^3\) and Umesh Kumar Patel\(^4\)
\(^{1}\) Professor, Department of Anesthesia, M.G.M. Medical College and M.Y. Hospital Indore, Madhya Pradesh, India.
\(^2\) Post Graduate, Department of Anesthesia, M.G.M. Medical College and M.Y. Hospital Indore, Madhya Pradesh, India.
\(^3\) Professor \& HOD, Department of Anesthesia, M.G.M. Medical College and M.Y. Hospital Indore, Madhya Pradesh, India.
\(^4\) Post Graduate, Department of Anesthesia, M.G.M. Medical College and M.Y. Hospital Indore, Madhya Pradesh, India.
Correspondence should be addressed to Aradhna Chourasiya at aradhnachourasiya50@gmail.com
Copyright © 2023 Rashmi Pal, Aradhna Chourasiya, K. K Arora and Umesh Kumar Patel. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: February 2, 2023 – Accepted: April 10, 2023 – Published: April 16, 2023
Abstract
Background: Central venous cannulation a vital intervention can be done using numerous approaches for cannulating the internal jugular vein such as anterior, posterior and approach. Of these, the anterior approach is being practised widely, since the identification of landmarks and palpation of carotid artery permits a beginner to learn the procedure easily. The major complications of this approach are carotid artery puncture and hematoma formation. Posterior approach needs identification of only the main bulk of the sternocleidomastoid muscle and external jugular vein, which could be identified even in obese patients easily by the trendelenberg position.
Aim: To evaluate and compare the success rates of anterior and posterior approach for internal jugular vein cannulation.
Material and methods: Hundred patients of American society of Anaesthesiologist (ASA) grade I and II, aged 20-60 years of age were divided into two groups. Group A patients were cannulated by anterior approach while Group-B patients cannulated by posterior approach. Number of attempts, time to identify vein, duration of cannulation, ease of threading and complications like carotid artery puncture, hematoma formation, pneumothorax, hemothorax, thrombophlebitis and catheter displacement were taken into consideration.
Result: The total number of attempts was statistically lower in group B as compared to group A (p value= 0.042). The mean time to identify vein and duration of cannulation was also found to be significantly lower in group B as compared to group A (p value= 0.0043,p value=0.001 respectively). The incidence of carotid artery puncture and hematoma formation was less in group-B as compared to group-A (p value=0.001).
Conclusion: Since Posterior approach for IJV cannulation required lesser number of attempts, less time to identify vein and also less duration of cannulation, It can be considered as a preferred choice for cannulation of internal jugular vein as compared to anterior approach.
Aim: To evaluate and compare the success rates of anterior and posterior approach for internal jugular vein cannulation.
Material and methods: Hundred patients of American society of Anaesthesiologist (ASA) grade I and II, aged 20-60 years of age were divided into two groups. Group A patients were cannulated by anterior approach while Group-B patients cannulated by posterior approach. Number of attempts, time to identify vein, duration of cannulation, ease of threading and complications like carotid artery puncture, hematoma formation, pneumothorax, hemothorax, thrombophlebitis and catheter displacement were taken into consideration.
Result: The total number of attempts was statistically lower in group B as compared to group A (p value= 0.042). The mean time to identify vein and duration of cannulation was also found to be significantly lower in group B as compared to group A (p value= 0.0043,p value=0.001 respectively). The incidence of carotid artery puncture and hematoma formation was less in group-B as compared to group-A (p value=0.001).
Conclusion: Since Posterior approach for IJV cannulation required lesser number of attempts, less time to identify vein and also less duration of cannulation, It can be considered as a preferred choice for cannulation of internal jugular vein as compared to anterior approach.
Keywords:
Cannulation; Carotid artery; Hematoma; Internal jugular vein.