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一项比较成年患者经超声引导与传统触诊法行胫后动脉置管的随机对照试验。

A randomized controlled trial comparing ultrasound-guided versus traditional palpatory methods of posterior tibial artery cannulation in adult patients.

机构信息

Department of Trauma & Emergency (Anaesthesiology), All India Institute of Medical Sciences, Jodhpur, India.

Department of Anaesthesiology & Critical Care, All India Institute of Medical Sciences, Jodhpur, India.

出版信息

J Vasc Access. 2024 Jul;25(4):1140-1145. doi: 10.1177/11297298231152280. Epub 2023 Jan 31.

Abstract

BACKGROUND

The palpation method of posterior tibial artery cannulation has not yet been compared to ultrasound-guided posterior tibial artery cannulation in adults. This research examined whether using ultrasound to cannulate the posterior tibial artery enhances first-pass cannulation success and lowers total procedure time.

METHODS

In this randomized controlled experiment, 76 adult patients were included who were undergoing surgery under general anesthesia and required artery cannulation. Cannulation of the posterior tibial artery was performed utilizing either an ultrasound-assisted method (group U) or a palpation method (group P). Data were analyzed for cannulation success on the first attempt, number of cannulation attempts, assessment time, cannulation time, and total procedure time.

RESULTS

The P group had a considerably shorter mean assessment time than the U group [14.29 ± 2.79 s vs 20.89 ± 2.70 s; p < .001]. Moreover, cannulation time was substantially longer in the P (29.20 ± 12.60 s) than in the U group (15.90 ± 6.50 s) (p < .001). The total procedure time remained statistically more in the P group than in the U group (p = 0.007). The rate of successful posterior tibial artery cannulation on the first attempt was comparable between the two groups (63.2% in the U and 55.3% in the P group, respectively; p = .484)].

CONCLUSIONS

The posterior tibial artery may be a suitable alternative to arterial cannulation for individuals with multiple failed attempts or difficult access. The application of ultrasound during posterior tibial artery cannulation in adult patients is safe and feasible and accompanied by a reduction in cannulation and total procedure time. The rate of first-attempt successful posterior tibial artery cannulation was comparable between the two groups.

摘要

背景

在后胫骨动脉穿刺中,触诊法尚未与超声引导下的后胫骨动脉穿刺进行比较。本研究旨在探讨在成人中使用超声进行后胫骨动脉穿刺是否能提高首次穿刺成功率并降低总操作时间。

方法

这是一项随机对照试验,共纳入 76 例接受全身麻醉下手术且需要动脉穿刺的成年患者。采用超声辅助法(U 组)或触诊法(P 组)进行后胫骨动脉穿刺。分析首次尝试穿刺成功率、穿刺次数、评估时间、穿刺时间和总操作时间。

结果

P 组的平均评估时间明显短于 U 组[14.29±2.79s 比 20.89±2.70s;p<0.001]。此外,P 组的穿刺时间明显长于 U 组[29.20±12.60s 比 15.90±6.50s;p<0.001]。P 组的总操作时间仍明显长于 U 组(p=0.007)。两组首次尝试后胫骨动脉穿刺成功率相当(U 组 63.2%,P 组 55.3%;p=0.484)。

结论

对于多次尝试失败或穿刺困难的患者,后胫骨动脉可能是动脉穿刺的替代选择。在成人患者中,应用超声进行后胫骨动脉穿刺是安全可行的,可缩短穿刺和总操作时间。两组首次尝试后胫骨动脉穿刺成功率相当。

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