Furuta Kazuyoshi, Asai Takashi, Suzuki Hiroaki, Saima Shunsuke, Okuda Yasuhisa
Department of Anesthesiology, Dokkyo Medical University Saitama Medical Center, 2-1-50, Minami-Koshigaya, Koshigaya, Saitama, 343-8555, Japan.
J Anesth. 2025 Feb;39(1):41-48. doi: 10.1007/s00540-024-03419-0. Epub 2024 Nov 10.
The radial artery is commonly selected for arterial puncture and cannulation, but radial nerve palsy may occur. To minimize possible damage to the nerve, needle puncture should be made within the margin of safety (between the wrist to the distal end of the radial artery and the radial nerve running in parallel). In adults, the margin of safety for radial artery puncture is approximately 6.8 cm from the wrist in men and approximately 5.4 cm in women, but the margin of safety is not known in children of different age groups.
Using an ultrasound device, we measured the margin of safety in 100 anesthetized patients aged 0 months to 15 yr. Polynomial quadratic regression models were made, and the lower limit of the prediction interval was regarded as the margin of safety. These results were then compared with the results obtained in adults.
The margin of safety became wider as a child grows older, and the height, weight, and age were all suitable explanatory variables to predict the margin of safety, providing fairly a constant predicted margin of safety from a few millimeters in neonates to approximately 4 cm in adolescents (much narrower than in adults).
In children and adolescents, the margin of safety for radial artery puncture is much narrower than in adults, and these findings support the recommendation to use ultrasound guidance during radial artery puncture in children and adolescents, to minimize the risk of associated complications.
jRCT1032230243.
桡动脉常被选用于动脉穿刺和置管，但可能会发生桡神经麻痹。为尽量减少对神经的潜在损伤，应在安全范围内（在腕部至桡动脉远端与并行的桡神经之间）进行针刺。在成人中，桡动脉穿刺的安全范围在男性中距腕部约6.8厘米，在女性中约为5.4厘米，但不同年龄组儿童的安全范围尚不清楚。
我们使用超声设备测量了100例年龄在0个月至15岁的麻醉患者的安全范围。建立了多项式二次回归模型，并将预测区间的下限视为安全范围。然后将这些结果与在成人中获得的结果进行比较。
随着儿童年龄的增长，安全范围变宽，身高、体重和年龄都是预测安全范围的合适解释变量，从新生儿的几毫米到青少年的约4厘米提供了相当恒定的预测安全范围（比成人窄得多）。
在儿童和青少年中，桡动脉穿刺的安全范围比成人窄得多，这些发现支持在儿童和青少年桡动脉穿刺期间使用超声引导的建议，以尽量减少相关并发症的风险。
jRCT1032230243。
