Comparison of catheterization of internal jugular vein by ultrasound guided versus landmark approach IN I.C.U. patients
Journal Title: Indian Journal of Clinical Anaesthesia - Year 2018, Vol 5, Issue 3
Abstract
Introduction Central venous line placement is one of the essential procedures in the treatment of critically ill patients admitted in the intensive care unit Central venous catheterization is required not only for providing a route for delivery of the caustic or critical medications but it also allows for the measurement of central venous pressure Being an invasive procedure it has a learning curve and is associated with many complications Hence we conducted the study comparing catheterization of internal jugular vein by ultrasound guided versus landmark approach with respect to the ease of insertion and related complications in Intensive Care Unit ICU patientsMaterials and Methods 150 patients admitted in the ICU fulfilling the inclusion criteria were divided into two groups based on computer generated randomization table namely group A landmark technique and group B USG technique comprising of 75 patients in each group In landmark approach the internal jugular vein was located at the apex of triangle formed by the sterna and clavicular heads of sternocleidomastoid muscle and needle was directed towards the ipsilateral nipple when advanced through skin lateral to the carotid artery pulsations with artery being pushed medially In USG guided approach the linear USG probe of 7 MHz connected to a realtime Kontron Medical ultrasound unit was used with standard twodimensional 2D ultrasound imaging to identify the IJV Catheterization was performed realtime by placing the transducer of the ultrasound parallel and superior to clavicle over the groove between the two heads of the sternocleidomastoid muscle SAX view A postprocedure xray of chest was done as early as possible to assess the placement of CVC and rule out any complicationResults The two groups were comparable in age sex and body mass index There was no statistically significant difference in the mean number of attempts taken for catheterization of IJV between the two groups pvalue0124 However the mean time taken for cannulation of IJV was found to be significantly lower in the USG group as compared to the landmark group pvalue003 The overall rate of complications was significantly higher in group A p0012Conclusion Ultrasonography guidance significantly reduced the total procedural time and the rate of complications during internal jugular vein cannulation compared to the landmark technique Keywords Internal jugular vein Central venous catheterization Landmark approach Ultrasound guided approach
Authors and Affiliations
Swati Choraria, Nitin Choudhary, Harish C. Sachdeva, Sushil Guria
Keywords
Related Articles
- EP ID EP476519
- DOI 10.18231/2394-4994.2018.0082
- Views 88
- Downloads 0
A prospective study of associated surgical hazards in trans-urethral resection of bladder tumor (turbt) comparing blind versus nerve stimulator guided obturator nerve block with spinal block
Introduction: Bladder cancer is the ninth most commonly diagnosed cancer worldwide. The overall incidence has increased by 10% since last 30 years and 5 years survival rate by 50% in European countries.1 Transurethral re...
Attenuation of sympathetic pressor responses to laryngoscopy and intubation in patients with preeclampsia: Comparison between IV lignocaine and IV lignocaine with labetalol
Introduction: tracheal intubation and laryngoscopy are invariably associated with reflex sympathetic pressor responses resulting in elevated HR & BP. This may prove detrimental in preeclampsia patients. Objectives: To co...
A randomized controlled double blind study comparing the efficacy of epidural ropivacaine and bupivacaine with fentanyl for labor analgesia
Introduction and Aim Ropivacaine and bupivacaine have been found to provide adequate labor analgesia when given epidurally The aim of this randomized double blind study was to compare the onset of sensory block in epidur...
Attenuation of pressor response to laryngoscopy and intubation: Dexmedetomidine Vs. fentanyl premedication
Introduction The pressor response during laryngoscopy and intubation is part of a huge spectrum of stress response results from the increase in sympathetic and sympathoadrenal activity The present study was planned to ob...
Excision of right nasolabial cyst under intra oral infra orbital nerve block – a case report and a short review
Nasolabial cyst is quite a rare non-odontogenic, soft-tissue cyst forming in the sublabial area and the anterior maxillary region. The patients present to us with a slowly enlarging swelling, usually without any symptoms...