Abstract
A 65 year old female patient underwent right pterional craniotomy for clipping of anterior communicating artery aneurysm. The subclavian vein cannulation was done after induction of anaesthesia and a pressure transducer was attached but the absence of typical waveforms led to doubt of correct placement of the catheter. An internal jugular vein (IJV) occlusion test showed flattened trace and central venous pressure (CVP) rise of 5 mmHg indicating misplacement of the catheter into the IJV, later confirmed by chest roentgenogram. The central venous catheter (CVC) was withdrawn to the 4 cm mark and reinserted after applying pressure over the ipsilateral IJV. The position of the CVC was rechecked by connecting a pressure transducer. This time after IJV occlusion, the CVP trace was good and there was no change in waveforms and CVP reading.
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