Comparison of Three Techniques for Ultrasound Guided Internal Jugular Vein Cannulation

BACKGROUND \nIn any given hospital set up, obtaining venous access is of utmost significance. \nCentral venous catheterization is now an unavoidable component for invasive \nmonitoring and management. Central venous access was first given by Aubaniac1 \nin 1953. Cannulation of the internal jugular vein is a procedure commonly \nperformed by anaesthetists, in both the perioperative period and in intensive care.2 \nThe internal jugular route for central venous access has been described as early \nas in 1966 by Hermosura.3 The very first and one of the most commonly followed \nmethod for central venous catheterization remains a blind surface landmarkguided technique. Ultrasonography guidance in central venous cannulation has \nconverted a blind procedure into a procedure under vision which helps in reducing \nthe complication rates. The aim of the study is to compare three ultrasound guided \ntechniques (short axis vs long axis vs oblique axis) for cannulation of the right \ninternal jugular vein. \nMETHODS \nThis is an observational study conducted among 151 patients who fulfilled the \ninclusion criteria and who had given a written informed consent. The patients were \ndivided into groups of 51 each. Group 1- Short axis approach (SAX), Group 2- Long \naxis approach (LAX), Group 3- Oblique axis approach (OAX). The outcome \nvariables used were- 1. Successful cannulation with the designated approach, 2. \nFirst needle pass success n (%), 3. Number of needle passes, 4. Cannulation time \n(s). 5. Complications. \nRESULTS \nThe findings of the study indicate that Oblique axis approach to IJV cannulation is \nbetter than Long or Short axis approach in terms of number of needle passes, first \nneedle pass success, and cannulation time . There was no statistically significant \ndifference in complication rates among the three groups. \nCONCLUSIONS \nIt can be concluded that while performing ultrasound guided Internal Jugular Vein \ncannulation, the Oblique axis approach can be considered as a safe and effective \napproach.