International Journal of Medical Anesthesiology
2021, Vol. 4, Issue 1, Part C
Ultrasound guidance versus direct palpation for radial artery cannulation in adults undergoing cardiac surgery post transradial catheterization
Author(s): Dr. Harish Nadagoudar and Dr. Vinayak Panchgar
Background: Arterial cannulation is a frequent and essential procedure for continuous blood pressure monitoring and arterial blood sampling. The radial artery is the most commonly used for arterial cannulation. Radial access for coronary angiogram & intervention is increasingly used worldwide. Patients undergoing repeated transradial cannulation in same arm, the rate of radial access site failure increased with successive procedure. Traditional placement of radial artery cannulation is performed by using anatomical knowledge and pulse palpation as a guide. Ultrasound can facilitate access to artery and is useful in patients with low perfusion, arrhythmias, obesity and previously unsuccessful attempts with palpation technique. Attempt is made to evaluate the better procedure among traditional direct palpation Radial artery cannulation and USG guided cannulation in this study.
Methodology: A total of 86 patients undergoing cardiac surgery post transradial catheterization were selected and randomized into ultrasound group and palpation group. It is a prospective, randomized, interventional study. Both the techniques were compared in terms of Total number of attempts, Time taken to cannulate, Complication related to procedure, Failure rate, Number of cannula used. Statistical analysis was performed by the software SPSS 22.0 version. Normality was checked by Shapiro Wilk test. To find the significant difference in means of two groups we used independent t-test and to find the association between categorical variables we used chi-square test or Fishers Exact test. p value <0.05 was considered as statistically significant.
Results: Out of the 86 patients, the initial randomized method was successful in 81 patients (42/43 in USG and 39/43 in DPG group). USG group had a mean cannulation time of 57.1 seconds while in DPG group mean time was 81.51 seconds with a standard deviation of 24.923 and 50.83 respectively with p value was 0.009. The mean number of attempts in USG group is 1.24 with standard deviation of.484, in DPG group mean was 1.59 and standard deviation was 0.91 with a p value of 0.036 which is statistically significant. Even though, number of cannulas used in ultrasound group was fewer compared to palpation group, it was not statistically significant. Ultrasound showed less failure rate but statistically not significant with p value of 0.167.
Conclusion: The use of ultrasound for radial artery cannulation in post transradial artery catheterized patients helps in faster insertion of cannula, requires less attempt for cannulation compared to traditional palpatory method. The complications were very low for both the methods, so ultrasound did not offer any advantage regarding reduction of complications following arterial cannulation.
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How to cite this article:
Dr. Harish Nadagoudar, Dr. Vinayak Panchgar. Ultrasound guidance versus direct palpation for radial artery cannulation in adults undergoing cardiac surgery post transradial catheterization. Int J Med Anesthesiology 2021;4(1):168-173. DOI: 10.33545/26643766.2021.v4.i1c.217