Ultrasound guided internal jugular venous cannulation: comparison with land-mark technique

ABSTRACT

To compare real-time ultrasonography-guided technique versus the traditional land-mark technique for internal Jugular venous cannulation. Randomized controlled trial. Department of Anaesthesia, Combined Military Hospital, Rawalpindi, from September 2013 to July 2014. A total of 200 patients who required internal jugular vein cannulation were randomly assigned using either real-time ultrasound-guided technique or land-mark technique. Access time, number of attempts until successful cannulation, complications and the demographics of each patient were recorded. Access time was significantly less in real-time ultrasound group [34.95 +/- 11.47 vs. 146.59 +/- 40.20 seconds, p < 0.001]. Cannulation was performed in first attempt in 99% of patients in ultrasound group as compared to 89% of landmark group. Complication rate was significantly higher in the land-mark group than in the ultrasound-guided group. Carotid artery puncture rate [9% vs. 1%] and haematoma formation [7% vs. 0%] were more frequent in the land-mark group than in the ultrasound-guided group. Brachial plexus irritation was also more in land-mark group [6% vs. 0%]. Access time, failure rate and procedure related complications are reduced when real-time ultrasonography is used to cannulate internal Jugular vein