Comparison of Ultrasound Guided Dynamic Needle Tip Positioning Technique and Conventional Long-Axis In-Plane Technique for Radial Arterial Cannulation in Adults Requiring Radial Arterial Cannulation

INTRODUCTION

Arterial cannulation is a common invasive procedure performed in operating theatres and intensive care units. Radial artery is most commonly selected due to its superficial course, double blood supply of the hand and lower risk of complications. Multiple failed attempts at radial arterial cannulation can lead to arterial spasm and patient dissatisfaction. The use of ultrasound increases the success rates of radial arterial cannulation. Conventionally, there are two methods of radial arterial cannulation viz., Short-Axis Out-of-Plane technique and Long-Axis In-Plane technique. The short-axis ultrasound technique has the advantage of better visualization of relevant anatomy, such as abnormal vascular anatomy, nerves, and veins during arterial cannulation. The long-axis technique can provide clear visualization of the position of the needle tip as it approaches and enters the arterial lumen and thus enhance the success rate of threading of a catheter. Dynamic needle tip positioning technique is a  new technique combining the two methods. This study was done in order to compare the Dynamic Need Tip Positioning Technique with the conventional Long-Axis In-Plane method.

AIM

To compare ultrasound guided dynamic needle tip positioning technique and conventional long- axis in-plane technique for radial arterial cannulation in adults requiring radial arterial cannulation. 

OBJECTIVES 

1.To assess the success rate among ultrasound guided dynamic needle tip positioning technique in adults adults requiring radial arterial cannulation 

2.To assess the success rate among ultrasound guided long-axis, in-plane technique in adults requiring radial arterial cannulation 

3.To compare the success rates among these two groups viz. ultrasound guided dynamic needle tip positional technique and ultrasound guided long-axis, in-plane technique in adults requiring radial arterial cannulation 

HYPOTHESIS 

Ultrasound guided dynamic needle tip positioning technique is better than conventional long- axis in-plane technique for radial arterial cannulation in adults requiring radial arterial cannulation

MATERIALS AND METHODS

Hospital based observational study for patients from 18 to 90 years from Amala Institute of Medical Sciences, Thrissur to be done on 114 patients with 57  each in both Dynamic Needle Tip Positioning Technique group and Long-Axis In-Plane technique group. Radial arterial cannulation will be performed by a experienced anaesthesiologists with more than 5 years experience in ultrasound guided radial arterial cannulation under strict aseptic precautions.. Instituitional Ethical Committee approval has been obtained and informed written consent will be taken in local language from all patients and relevant data will be collected. Confidentiality of the patients will be maintained. The data obtained will be coded in Microsoft Excel sheet and statistical analysis will be done using SPSS software.