Department of Anaesthesiology, Intensive Care, Palliative Care and Pain Medicine, BG University Hospital Bergmannsheil, Bochum, Germany.
Anaesthesia. 2015 Nov;70(11):1242-9. doi: 10.1111/anae.13187. Epub 2015 Aug 28.
The objective of this prospective, randomised study was to examine the impact of a multi-angle needle guide for ultrasound-guided, in-plane, central venous catheter placement in the subclavian vein. One hundred and sixty patients were randomly allocated to two groups, freehand or needle-guided, and then 159 catheterisations were analysed. Cannulation of the first examined access site was successful in 96.9% of cases with no significant difference between groups. There were three arterial punctures and no other severe injuries. Catheter misplacements did not differ between the groups. Higher success rates within the first and second attempts in the needle-guided group were observed (p = 0.041 and p = 0.019, respectively). Use of the needle guide reduced the access time from a median (IQR [range]) of 30 (18-76 [6-1409]) s to 16 (10-30 [4-295]) s; p = 0.0001, and increased needle visibility from 31.8% (9.7%-52.2% [0-96.67]) to 86.2% (62.5%-100% [0-100]); p < 0.0001. A multi-angle needle guide significantly improved aligning the needle and ultrasound plane compared with the freehand technique when cannulating the subclavian vein. Use of the guide resulted in faster access times and increased success at the first and second attempts.
本前瞻性、随机研究旨在探讨多方位穿刺导针在超声引导下锁骨下静脉平面内中心静脉置管中的应用效果。将 160 例患者随机分为徒手组和导针组，分析了 159 例置管操作。首次检查的入路穿刺均成功，两组间无显著差异。有 3 例动脉穿刺，无其他严重损伤。导管位置不良两组间无差异。导针组首次和第二次尝试的成功率更高（p = 0.041 和 p = 0.019）。导针的使用使入路时间从中位数（IQR [范围]）30 秒（18-76 秒[6-1409 秒]）减少至 16 秒（10-30 秒[4-295 秒]）；p = 0.0001，且提高了针的可视性从 31.8%（9.7%-52.2%[0-96.67%]）至 86.2%（62.5%-100%[0-100%]）；p < 0.0001。与徒手技术相比，多方位穿刺导针在穿刺锁骨下静脉时能更有效地使针与超声平面对齐。导针的使用使入路时间更短，首次和第二次尝试的成功率更高。
