Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Anesthesiology, Chongqing University Cancer Hospital, Chongqing, China.
PLoS One. 2023 Dec 19;18(12):e0295916. doi: 10.1371/journal.pone.0295916. eCollection 2023.
Modified combined short and long axis method (MCSL) can replace oblique axis in-plane method (OA-IP) for internal jugular vein cannulation (IJVC). This randomized, non-inferiority study estimated the efficacy of MCSL compared with OA-IP in right IJVC.
Patients (18-75 yr. old) undergoing right IJVC under local anesthesia were randomly assigned to MCSL or OA-IP group. The primary outcome is the event of first needle pass without posterior vessel wall puncture (PVWP). Secondary outcomes included needle attempts, success rate, puncture and cannulation time, needle visualization, probe placement difficulty and complications.
Among 190 randomized patients, 187 were involved in the analysis. The first needle pass without PVWP was 85(89.47%) in the MCSL and 81 (85.26%) in the OA-IP (p = 0.382), with a mean rate difference of 4.2% (95% confidence interval: -5.2-13.6), which confirmed the non-inferiority with the margin of -8%. MCSL group exhibited shorter procedure time and lower complications than OA-IP group. No significant differences were discovered between groups in needle attempts, success rate, incidence of probe placement difficulty and needle visualization.
MCSL is non-inferior to OA-IP in first needle pass without PVWP in adults who underwent elective right IJVC and associate with less complications and shorter operating time.
ChiCTR, ChiCTR2100046899.
改良的短轴联合长轴法（MCSL）可替代斜轴平面内法（OA-IP）用于颈内静脉置管（IJVC）。这项随机、非劣效性研究旨在评估 MCSL 与 OA-IP 在右侧 IJVC 中的效果。
在局部麻醉下接受右侧 IJVC 的患者（18-75 岁）被随机分配至 MCSL 或 OA-IP 组。主要结局是首次无后壁血管穿刺（PVWP）的针道通过事件。次要结局包括针道尝试次数、成功率、穿刺和置管时间、针道可视化、探头放置难度和并发症。
在 190 名随机患者中，187 名患者纳入分析。MCSL 组首次无 PVWP 的针道通过率为 85（89.47%），OA-IP 组为 81（85.26%）（p = 0.382），平均率差为 4.2%（95%置信区间：-5.2-13.6），证实了 8%的非劣效性边界。MCSL 组的手术时间更短，并发症发生率更低。两组在针道尝试次数、成功率、探头放置难度发生率和针道可视化方面无显著差异。
在择期行右侧 IJVC 的成人中，MCSL 与 OA-IP 相比，首次无 PVWP 的针道通过率无差异，且并发症更少，手术时间更短。
ChiCTR，ChiCTR2100046899。
