Comparison of Landmark v/s USG Guided Technique for Internal Jugular Vein Cannulation in Adult Patients Undergoing Cardiac Surgery

Man Bhavan Mahajan; Indu Verma; Rupali Mahajan; Karthik Kateel

doi:10.18502/aacc.v9i5.13961

Man Bhavan Mahajan Department of Anesthesiology, S.M.S Medical College, Jaipur, India.
Indu Verma Department of Anesthesiology, S.M.S Medical College, Jaipur, India.
Rupali Mahajan Department of Anesthesiology, Civil Hospital, Fazilka, India.
Karthik Kateel Department of Anesthesiology, S.M.S Medical College, Jaipur, India.

DOI: https://doi.org/10.18502/aacc.v9i5.13961

Keywords: Central venous catheterization; Anatomical landmarks; Real time USG;

Abstract

Background: Obtaining central venous access is the basic requirement in patients undergoing cardiac surgery. Use of ultrasound (USG) for accessing IJV cannulation, improves the success rate and reduces the number of complications that may arise due to blind approach. Through this study we aimed to compare landmark vs real time USG guided IJV cannulation techniques.

Methods: 190 adult patient’s undergoing cardiac surgery were randomly divided into two groups of 95 each. Patients in Group A (Landmark based approach) were being compared to Group B (USG based) in terms of – success rate, first attempt success rate, total cannulation time, number of attempts, complications and success rate among residents and consultants.

Results: Success rate obtained in Group A was 89.4% compared to 100% in group B (P = 0.001). First attempt success rate was 67.36% in group A and 91.57% in group B (P < 0.001). Group B showed less number of attempts. Total cannulation time in group A (252.2 ± 66.4) sec was significantly higher (P<0.001) than group B (182.5 ± 40.39) sec. Rate of complications such as hematoma formation and carotid artery puncture were also significantly higher in group A.

Conclusion: The real time USG guided IJV cannulation is better technique than Landmark guided approach as it has significantly higher success rate, reduces the number of attempts, reduces the total time for cannulation and decreases the rate of complications. Also, success rate even increases among junior residents with the use of USG.