Azmat Riaz, Rao Ali Shan Khan, Faisal Salim.
Ultrasound Guided Internal Jugular Venous Cannulation: Comparison with Land-Mark Technique.
J Coll Physicians Surg Pak Jan ;25(5):315-9.

Objective: To compare real-time ultrasonography-guided technique versus the traditional land-mark technique for internal Jugular venous cannulation. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Anaesthesia, Combined Military Hospital, Rawalpindi, from September 2013 to July 2014. Methodology: A total of 200 patients who required internal jugular vein cannulation were randomly assigned using either real-time ultrasound-guided technique or land-mark technique. Access time, number of attempts until successful cannulation, complications and the demographics of each patient were recorded. Results: Access time was significantly less in real-time ultrasound group (34.95 ± 11.47 vs. 146.59 ± 40.20 seconds, p < 0.001). Cannulation was performed in first attempt in 99% of patients in ultrasound group as compared to 89% of landmark group. Complication rate was significantly higher in the land-mark group than in the ultrasound-guided group. Carotid artery puncture rate (9% vs. 1%) and haematoma formation (7% vs. 0%) were more frequent in the land-mark group than in the ultrasound-guided group. Brachial plexus irritation was also more in land-mark group (6% vs. 0%). Conclusion: Access time, failure rate and procedure related complications are reduced when real-time ultrasonography is used to cannulate internal Jugular vein.

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