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Ju JW, Hwang Y, Lee HJ. Retrospective analysis of the feasibility and safety of external jugular vein cannulation in surgical patients. Anesth Pain Med (Seoul) 2023; 18:84-91. [PMID: 36746907 PMCID: PMC9902628 DOI: 10.17085/apm.22171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 10/01/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Establishing intravenous (IV) access is an essential procedure in surgical patients. External jugular vein (EJV) cannulation can be a good alternative for patients forwhom it is difficult to establish peripheral IV access. We aimed to investigate the feasibilityand safety of EJV cannulation in surgical patients. METHODS We performed a retrospective review of EJV cannulation in patients who underwent anesthesia for surgery at a tertiary hospital between 2010 and 2021. We collectedclinical characteristics, including EJV cannulation-related variables, from the anesthetic records. We also investigated the EJV cannulation-related complications, which included anyEJV cannulation-related complications (insertion site swelling, infection, thrombophlebitis,pneumothorax, and arterial cannulation) within 7 days after surgery, from the electronicmedical records during the hospitalization period for surgery. RESULTS We analyzed 9,482 cases of 9,062 patients for whom EJV cannulation was performed during anesthesia. The most commonly performed surgery was general surgery(49.6%), followed by urologic surgery (17.5%) and obstetric and gynecologic surgery (15.7%).Unplanned EJV cannulation was performed emergently during surgery for 878 (9.3%) cases.The only EJV cannulation-related complication was swelling at the EJV-cannula insertion site(65 cases, 0.7%). There was only one case of unplanned intensive care unit admission dueto swelling related to EJV cannulation. CONCLUSIONS Our study showed the feasibility and safety of EJV cannulation for surgical patients with difficult IV access or those who need additional large-bore IV access during surgery. EJV cannulation can provide safe and reliable IV access with a low risk of major complications in a surgical patient.
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Affiliation(s)
- Jae-Woo Ju
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea
| | - Yoonbin Hwang
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea
| | - Ho-Jin Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea,Address for Correspondence: Ho-Jin Lee, M.D., Ph.D. Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea Phone: 82-2-2072-2467 FAX: 82-2-747-8363 E-mail:
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De Cassai A, Geraldini F, Pasin L, Boscolo A, Zarantonello F, Tocco M, Pretto C, Perona M, Carron M, Navalesi P. Safety in training for ultrasound guided internal jugular vein CVC placement: a propensity score analysis. BMC Anesthesiol 2021; 21:241. [PMID: 34625054 PMCID: PMC8499568 DOI: 10.1186/s12871-021-01460-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/01/2021] [Indexed: 11/30/2022] Open
Abstract
Background Central venous catheter (CVC) placement is a routine procedure but is potentially associated with severe complications. Relatively small studies investigated if the use of ultrasound is effective in bridging the skill gap between proficient and not proficient operators, while patient safety during training remains a controversial topic. The first aim of this study was to evaluate if resident proficiency affects the failure rate in CVC positioning under ultrasound guidance. In addition, it aimed to investigate the different rate of complications between proficient and non proficient residents. Methods We conducted a cohort study including CVC placed by residents at the University Hospital of Padova, from November 1, 2012 to July 9, 2020 comparing proficient and non proficient residents. To avoid bias the two cohorts were matched using propensity score. Results A total of 356 residents positioned 2310 CVC during the 8 year study period. Among them, two groups of 1060 CVCs each were matched with a propensity score analysis. There was no difference in the failure rate among the groups (2.8 vs 2.7%, p-value 0.895). Moreover, cohorts had the same rate of hematomas, catheter tip malposition, arterial puncture and pneumothorax. No cases of hemothorax were reported. Conclusions We found the same rate of success and incidence of adverse complications among cohorts, meaning that the process of skill acquisition is safe as long as appropriate training and direct supervision by a senior consultant are available.
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Affiliation(s)
- Alessandro De Cassai
- UOC Anaesthesia and Intensive Care Unit, University Hospital of Padua, 13, Gallucci St., 35121, Padua, Italy
| | - Federico Geraldini
- UOC Anaesthesia and Intensive Care Unit, University Hospital of Padua, 13, Gallucci St., 35121, Padua, Italy
| | - Laura Pasin
- UOC Anaesthesia and Intensive Care Unit, University Hospital of Padua, 13, Gallucci St., 35121, Padua, Italy.
| | - Annalisa Boscolo
- UOC Anaesthesia and Intensive Care Unit, University Hospital of Padua, 13, Gallucci St., 35121, Padua, Italy
| | - Francesco Zarantonello
- UOC Anaesthesia and Intensive Care Unit, University Hospital of Padua, 13, Gallucci St., 35121, Padua, Italy
| | - Martina Tocco
- UOC Anaesthesia and Intensive Care Unit, University Hospital of Padua, 13, Gallucci St., 35121, Padua, Italy
| | - Chiara Pretto
- UOC Anaesthesia and Intensive Care Unit, University Hospital of Padua, 13, Gallucci St., 35121, Padua, Italy
| | - Matteo Perona
- UOC Anaesthesia and Intensive Care Unit, University Hospital of Padua, 13, Gallucci St., 35121, Padua, Italy
| | - Michele Carron
- UOC Anaesthesia and Intensive Care Unit, University Hospital of Padua, 13, Gallucci St., 35121, Padua, Italy.,UOC Anaesthesia and Intensive Care Unit, Department of Medicine-DIMED, University of Padua, Padua, Italy
| | - Paolo Navalesi
- UOC Anaesthesia and Intensive Care Unit, University Hospital of Padua, 13, Gallucci St., 35121, Padua, Italy.,UOC Anaesthesia and Intensive Care Unit, Department of Medicine-DIMED, University of Padua, Padua, Italy
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Nagase T, Tokunaga K, Watanabe K, Umeda T, Suruga Y, Takasugi Y, Inoue S, Kiriyama H, Matsumoto K. A Patient with a Cavernous Sinus Dural Arteriovenous Fistula in Whom an Approach through the Jugular Venous Arch Involving Facial Vein Return Was Adopted. JOURNAL OF NEUROENDOVASCULAR THERAPY 2020; 15:164-169. [PMID: 37502728 PMCID: PMC10370671 DOI: 10.5797/jnet.cr.2020-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 07/24/2020] [Indexed: 07/29/2023]
Abstract
Objective We report the case of a cavernous sinus dural arteriovenous fistula (CSdAVF) treated by transvenous embolization (TVE) via the jugular venous arch (JVA) connecting bilateral superficial cervical veins. Case Presentation A male patient in his 50s presenting with diplopia and headache was diagnosed with a CSdAVF. The first session of TVE resulted in incomplete obliteration of the fistula due to poor accessibility through the inferior petrosal sinus (IPS), and postoperative computed tomography angiography (CTA) disclosed a newly developed drainage route into the facial vein (FV) connecting to the anterior jugular vein (AJV) and the JVA. The patient underwent the second session of TVE through the JVA, FV, and the superior ophthalmic vein (SOV), and obliteration was achieved. Conclusion There is a considerable variation in the anatomy of facio-cervical veins in patients with CSdAVF. Meticulous preoperative evaluation of the venous drainage route using modern diagnostic tools is indispensable to achieve successful results in patients with CSdAVF.
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Affiliation(s)
- Takayuki Nagase
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Koji Tokunaga
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Kyoichi Watanabe
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Tsuyoshi Umeda
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Yasuki Suruga
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Yuji Takasugi
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Satoshi Inoue
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Hideki Kiriyama
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Kengo Matsumoto
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
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