Assessment of Intravenous Route Status in Preanesthetic Patients / 대한마취과학회지

ABSTRACT

Intravenous and/or "intracath" or "extracath" needles are used routinely for almost all undergoing anesthesia, no matter how minor. This preoperative intravenous puncture is usually performed by registered nurses in inpatient wards and the maintenance of these is very important to induce general/regional anesthesia even up to emergence from anesthesia. But sometimes they are likely to become dislodged/extravasated/disconnected just after arrival to operative theater, and then smooth and rapid anesthesia induction might be very difficult and delayed. Also, adhesive tape for reinforcement of the connection is not properly applied frequently. This article is to assess of injection site, type and size of needle, maintenance of indwelling needle, relationship of injection site with dominant extremity, and use of adhesive tape to reinforce the connection for anesthetic patients. Subjects are 267 adult and 45 pediatric patients. The results were as follows: 1) Injection site was forearm and dorsum of hand in 78% of adult patients while dorsum of hand and joints in 76% in pediatric patients. There is little difference to choose left/right extremity for intravenous routeQeft side in 52.8% of adult and 37.8% of pediatric patients). 2) Adult patients have mainly right-dominant arm(84.3%) and overall percentage of injection on dominant arm is 61.8%. 3) Extracath needles are mainly used in 96.6% of adult and 80% of pediatric patients except 20% of butterfly needle in newborn babies. 4) 18G and 20G needles are used in 29.6% and 66.7% of adult respectively while 20G and 22G in 13.3% and 71.1% of pediatric respectively except 23-24G mainly in newhorn babies. 5) Loose connection between needle hub and distal end of intravenous set is 85.8% of adult and 27.8% of pediatric patients. 62.2% of pediatric cases are needed variable sized armboard to fix the intravenous line. 6) Number of adhesive tape to reinforce the connection is 5-6 in over 60% in both adult and pediatric patients. 7) If the standard area of total adhesive tape is presumed 30 cm(2), 97% of adult and 100% of pediatric patients are over this value. With the above results, the authors recognized that selection of needle type and size are adequate but the maintenance, puncture site and use of adhesive plaster are inadeguate. So we should improve intravenous techniques for the patients.