Ju Jae-Woo, Hwang Yoonbin, Lee Ho-Jin
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
Anesth Pain Med (Seoul). 2023 Jan;18(1):84-91. doi: 10.17085/apm.22171. Epub 2022 Dec 5.
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.
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.
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.
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.
建立静脉通路是外科手术患者的一项基本操作。对于难以建立外周静脉通路的患者，颈外静脉（EJV）置管可能是一种不错的选择。我们旨在研究EJV置管在外科手术患者中的可行性和安全性。
我们对2010年至2021年期间在一家三级医院接受手术麻醉的患者的EJV置管情况进行了回顾性研究。我们从麻醉记录中收集了临床特征，包括与EJV置管相关的变量。我们还从手术住院期间的电子病历中调查了与EJV置管相关的并发症，包括术后7天内任何与EJV置管相关的并发症（穿刺部位肿胀、感染、血栓性静脉炎、气胸和动脉置管）。
我们分析了9062例患者的9482例EJV置管麻醉病例。最常进行的手术是普通外科手术（49.6%），其次是泌尿外科手术（17.5%）和妇产科手术（15.7%）。878例（9.3%）病例在手术期间紧急进行了非计划EJV置管。唯一与EJV置管相关的并发症是EJV导管插入部位肿胀（65例，0.7%）。因EJV置管相关肿胀导致计划外入住重症监护病房的病例仅有1例。
我们的研究表明，对于静脉通路困难或手术期间需要额外大口径静脉通路的外科手术患者，EJV置管具有可行性和安全性。EJV置管可为外科手术患者提供安全可靠的静脉通路，且主要并发症风险较低。
