Modified short-axis out-of-plane ultrasound versus conventional long-axis in-plane ultrasound to guide radial artery cannulation: a randomized controlled trial

ZheFeng Quan, Ming Tian, Ping Chi, YingHao Cao, Xin Li, KeJun Peng
Anesthesia and Analgesia 2014, 119 (1): 163-9

BACKGROUND: Currently, short-axis out-of-plane (SA-OOP) and long-axis in-plane (LA-IP) ultrasound techniques are used to guide radial artery cannulation. In this study, we compared the success rate of a modified SA-OOP technique with that of traditional LA-IP.

METHODS: One hundred sixty-four patients who were to undergo liver surgery or splenic resection under general anesthesia were included. Using a sealed envelope method, patients were randomly divided into 2 groups: the modified SA-OOP or the LA-IP ultrasound guidance approaches. The number of cannula insertion attempts until success was recorded in both groups. The primary end point to compare the groups was the rate of cannula insertion successes on the first attempt. The secondary end points were also recorded and compared: insertion failure rate, inner diameter of the radial artery, depth of artery from the skin, ultrasonic location time, cannulation time, and vascular complications including thrombosis, hematoma, edema, and vasospasm.

RESULTS: The cannula insertion success rate on the first attempt was significantly higher in the modified SA-OOP group compared with the LA-IP group (proportion difference 15.7%, 95% confidence interval [CI], 0.6%-30.7%, P = 0.0158). However, the insertion failure rate was not different between groups (95% CI, -17.7% to 12.8%, P = 0.4969). The ultrasonic location time was significantly decreased in the modified SA-OOP group compared with the LA-IP group (mean difference -9.5 seconds, 95% CI, -10.6 to -8.5 seconds, P < 0.0001). However, there was no significant difference between groups for cannulation time (95% CI, -0.6 to 7.6 seconds, P = 0.1152), depth of artery (95% CI, -0.07 to 0.57 mm, P = 0.1050), and the diameter of the radial artery (95% CI, -0.30 to 0.03 mm, P = 0.1153).

CONCLUSION: The modified SA-OOP technique may improve the success rate of cannula insertion into the radial artery on the first attempt.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"