Use of ultrasound guidance in the insertion of radial artery catheters

Abstract

Objective To assess the role of a portable ultrasound device in the insertion of radial artery catheters.Methods Elective surgery 132 patients [American society of anesthesiologists (ASA) grades Ⅰ-Ⅱ] requiring arterial catheter insertion for intraoperative monitoring.A total of 132 patients requiring an arterial catheter were randomized to either the ultrasound (B group,66 patients) or palpation technique (A group,66 patients).The time taken from skin puncture to successful arterial catheter insertion,the time taken per insertion attempt,and the number of attempts required were recorded for each group.A portable ultrasound device was used to visualize the radial artery at the wrist and to direct arterial catheter insertion.This new technique of arterial catheter insertion was compared with the classic palpation technique.Results There were four failures in the ultrasound group and four in the palpation group (not significant).Four cases out of the valid observations outside,so effectively observe objects in each group was 62 cases.Two groups of puncture succeed for the first time the example number compares B group to be bigger than A group (P＜0.05),The arterial cannula was inserted on the first attempt in 39 (63％)cases using ultrasound(B group) vs 21(34％) cases by palpation(A group) (P＜0.05); The total puncture number compares B group (98) to be smaller than obviously A group (195)(P＜0.05),Significantly fewer attempts were required for catheter insertion using ultrasound as compared with palpation (mean±SD),(1.6±2.0) and (3.1±2.4)(P＜0.05); however,the time taken for each successful attempt was longer (27.1±2.5) s and (17.5±1.8) s (P＜0.05).The shorter overall time required for catheter insertion was found for the ultrasound group (56±64) s and (112±124) s (P＜0.05).Conclusions Ultrasound is a useful adjunct to radial arterial catheter insertion and increases the rate of success at first attempt.The technique is easy to learn and can reduce the time taken to insert the catheter. Key words: Radial artery; Invasive monitoring; Ultrasound; Arterial cannulation