Simulating a Bloodless Surgical Field: A Study on Varying Relationship of Internal Jugular Vein and Common Carotid Artery with Neck Rotation.

To evaluate the intervarying relationship of IJV and CCA at supine and after simulating rotation to 15, 30 and 45 degrees respectively. A one year study was undertaken and 104 IJVs were evaluated at supine and after simulating 15-, 30- and 45-degree neck rotation to the contralateral side.The study had a male predilection of 68.63% over 33.33% females. Prior to simulating rotation, the IJV was Anterolateral (42%), Lateral (39%), Posterolateral (22%), Posterior (1%) and with subsequent rotation it assumed a more anterior relationship. The mean overlap of IJV and CCA was 27.7 at 0 degree, 32.93 at 15 degrees, 37.73 at 30 degree and 37.81 at 45-degree neck rotation and 26.7 at 0 degree, 29.24 at 15 degrees, 35.58 at 30 degree and 31.52 at 45-degree neck rotation on left; thereby showing increasing overlap with rotation.Special attention should be paid to anterior shifting of IJV relative to CCA induced with neck rotation. Taking this knowledge into account in the operative field can minimize surgical errors and intra operative complications.