用于桡动脉置管的触诊与超声引导下动态针尖定位技术对比

Palpation versus Ultrasound-Guided Dynamic Needle Tip Positioning Technique for Radial Artery Cannulation.

作者信息

Dhakal Sujan, Shrestha Gentle S, Lamsal Ritesh, Bastola Priska, Gautam Elija, Shrestha Anil

机构信息

Department of Anaesthesiology and Critical Care, Provincial Hospital Bhadrapur (PHB), Nepal.

Department of Anaesthesiology, Institute of Medicine (IOM), Tribhuvan University Teaching Hospital(TUTH), Nepal.

出版信息

Ann Card Anaesth. 2025 Jul 1;28(3):248-254. doi: 10.4103/aca.aca_209_24. Epub 2025 Jul 8.

DOI:10.4103/aca.aca_209_24

PMID:40629779

Abstract

INTRODUCTION

Invasive blood pressure monitoring is the clinical reference during perioperative patient management. It is usually performed by cannulating the radial artery. Different clinical conditions make arterial cannulation difficult using the conventional palpation (CP) method. This study compares the ultrasonography (USG)-guided dynamic needle tip positioning (DNTP) technique with the CP method to assess the first-pass success rate of radial artery cannulation.

METHODS

In the operation theater of a university hospital, a total of 52 adult patients requiring arterial cannulation were randomized into two equal groups. Arterial cannulation was performed using the CP method in one group and the ultrasound-guided DNTP method in the other group. The first-pass success rate was the primary objective. The 5-minute success rate, the time required for successful cannulation, the number of skin punctures, and the number of cannulae used were also compared using the Chi-square test, an independent sample t-test, and the Mann-Whitney U test.

RESULTS

The first-pass success rate was significantly higher in the USG-guided DNTP method (88.5%) compared to the CP method (46.2%) (P 0.001). The overall 5-minute success rate was 96.2% in the USG-guided DNTP and 65.4% (P 0.005) in the CP method. The median time for successful cannulation was significantly lesser in the USG-guided DNTP group [44 s (IQR: 35-72)] compared to the CP group [134 s (IQR: 28-378)] (P 0.007). The mean number of skin punctures in the USG-guided DNTP group was 1.15 ± 0.46 and 2.04 ± 1.18 in the CP group (P 0.001).

CONCLUSION

USG-guided DNTP method of radial artery cannulation increased the first-pass success rate.

摘要

引言

有创血压监测是围手术期患者管理的临床参考标准。通常通过桡动脉置管来进行。不同的临床情况使得使用传统触诊（CP）方法进行动脉置管变得困难。本研究比较了超声（USG）引导下动态针尖定位（DNTP）技术与CP方法，以评估桡动脉置管的首次穿刺成功率。

方法

在一所大学医院的手术室中，共有52名需要进行动脉置管的成年患者被随机分为两组，每组人数相等。一组采用CP方法进行动脉置管，另一组采用超声引导下的DNTP方法。首次穿刺成功率是主要目标。还使用卡方检验、独立样本t检验和曼-惠特尼U检验比较了5分钟成功率、成功置管所需时间、皮肤穿刺次数和使用的套管数量。

结果

与CP方法（46.2%）相比，超声引导下的DNTP方法的首次穿刺成功率显著更高（88.5%）（P<0.001）。超声引导下的DNTP组的总体5分钟成功率为96.2%，CP方法组为65.4%（P<0.005）。与CP组[134秒（四分位间距：28 - 378）]相比，超声引导下的DNTP组成功置管的中位时间显著更短[44秒（四分位间距：35 - 72）]（P<0.007）。超声引导下的DNTP组的平均皮肤穿刺次数为1.15±0.46，CP组为2.04±1.18（P<0.001）。