Effect of positive airway pressure on catheterization of right internal jugular vein in anesthetized patients / 中华麻醉学杂志

ABSTRACT

Objective To investigate the effect of positive airway pressure on catheterization of right internal jugular vein (IJV) in anesthetized patients. Methods One hundred and twenty-five ASA Ⅰ or Ⅱ patients aged 19-64 yr weighing 44-85 kg undergoing right IJV catheterization were randomly divided into 2 groups: control group (group C, n = 60) and positive airway pressure group (group P, n = 65). Anesthesia was induced with midazolam, sufentanil and etomidate. Tracheal intubation was facilitated with vecuronium. The patients were mechanically ventilated. Right IJV was catheterized under the guidance of ultrasound and was punctured at the plane of cricoid cartilage. IJV catheterization was performed when mechanical ventilation was suspended in group C and when airway pressure was maintained at 20 cm H2O in group P. The cross section area of right IJV, CVP, the shortest dislance between right IJV and the skin and the depth of needle insertion were measured. The number of attempts to puncture the vein was calculated and the easiness of withdrawing blood from the right IJV after being pierced was assessed. MAP and HR were measured before and after positive airway pressure. Results Positive airway pressure (20 cm H2O) significantly increased the cross section area of IJV, CVP, success rates of puncturing IJV at first attempt and within 30 seconds and easiness of withdrawing blood from IJV after being pierced and deceased the depth of needle insertion as compared with control group. Positive airway pressure (20 cm H2O) also significantly increased the incidence of bradycardia and hypotension. Conclusion Positive airway pressure is helpful for right IJV catheterization guided by ultrasound under general anesthesia.