Singh Akhil Kant, Khanna Puneet, Maitra Souvik, Baidya Dalim Kumar, Aggarwal Anil, Pangasa Neha, Som Anirban, Arora Mahesh Kumar
Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, Uttar Pradesh, India.
Department of Liver Transplant Anesthesia and Critical Care, Fortis Hospital, Noida, Uttar Pradesh, India.
J Indian Assoc Pediatr Surg. 2025 Jul-Aug;30(4):477-483. doi: 10.4103/jiaps.jiaps_280_24. Epub 2025 May 5.
The radial artery is the most preferred site for arterial cannulation in pediatric patients. The optimal wrist position which provides the largest size of the radial artery in pediatric patients is unknown.
We aimed to compare the sonoanatomy of the radial artery in different wrist positions (0°, 15°, 30°, 45°, 60°, and 75° extension) in pediatric patients to identify the optimal position which offered the largest diameter of the radial artery.
Ninety-six patients aged 1-12 years undergoing elective surgery were included. After induction of general anesthesia, an ultrasound examination of bilateral radial arteries was done. The wrist was placed in six different positions: 0°, 15°, 30°, 45°, 60°, and 75° extension, and radial artery anteroposterior diameter (APD), transverse diameter (TD), and depth from the skin (depth) were measured bilaterally using ultrasound.
The mean (±standard deviation [SD]) APD in the neutral wrist position was 1.79 (±0.45) mm and 1.76 (±0.47) mm on the right and left side, respectively. The mean (±SD) TD in the neutral wrist position was 2.32 (±0.47) mm and 2.35 (±0.68) mm on the right and left side, respectively. The mean (±SD) depth of the radial artery in the neutral wrist position was 1.75 (±0.70) mm and 1.65 (±0.76) mm on the right and left side, respectively. With increasing wrist angulation, both APD and TD did not show any significant change; however, depth decreased with increasing angulation. All measurements were comparable bilaterally.
In 1-12-year-old children, increasing wrist angulation leads to decreasing depth of the artery; however, the anteroposterior and Transverse diameter show no significant change.
桡动脉是小儿患者动脉穿刺最常用的部位。小儿患者中能提供最大桡动脉尺寸的最佳腕部位置尚不清楚。
我们旨在比较小儿患者不同腕部位置（0°、15°、30°、45°、60°和75°伸展）下桡动脉的超声解剖结构，以确定能提供最大桡动脉直径的最佳位置。
纳入96例年龄在1至12岁接受择期手术的患者。全身麻醉诱导后，对双侧桡动脉进行超声检查。将腕部置于六个不同位置：0°、15°、30°、45°、60°和75°伸展，使用超声双侧测量桡动脉前后径（APD）、横径（TD）以及距皮肤的深度（depth）。
中立腕部位置时，右侧平均（±标准差[SD]）APD为1.79（±0.45）mm，左侧为1.76（±0.47）mm。中立腕部位置时，右侧平均（±SD）TD为2.32（±0.47）mm，左侧为2.35（±0.68）mm。中立腕部位置时桡动脉的平均（±SD）深度，右侧为1.75（±0.70）mm，左侧为1.65（±0.76）mm。随着腕部角度增加，APD和TD均未显示出任何显著变化；然而，深度随角度增加而减小。所有测量值双侧具有可比性。
在1至12岁儿童中，腕部角度增加会导致动脉深度减小；然而，前后径和横径未显示出显著变化。
