■锁骨下静脉经常使用超声插管。锁骨下静脉置管(SVC)有两种技术:锁骨上(SC)和锁骨下(IC)。虽然IC路由通常是首选,SC方法提供了几个明显的优势。这项研究计划比较使用SC和IC方法的SVC技术在成人择期手术中的导管插入技术和并发症。
■招募了60名美国麻醉医师协会(ASA)1、2或3名在全身麻醉下进行择期手术的成年患者。患者随机分为SC或IC组。两组右锁骨下静脉插管(n=30)。可视化时间,李克特量表,锁骨下静脉直径,皮肤到锁骨下静脉的深度,尝试次数,穿刺时间,易于插入导丝,导管插入时间,并观察总手术时间。记录了每种方法的并发症比较。
■总程序时间,锁骨下静脉的可视化时间,SC组穿刺时间较低,IC组穿刺时间较高。IC方法的导管插入时间高于SC方法。SC组的超声视图评分优于IC组。SC组首次尝试成功率高于IC组。相对而言,SC入路术中和术后并发症均低于IC入路.
■超声检查(USG)引导下的SC入路可以更快地进入锁骨下静脉,相对安全,比IC方法更好的技术。此外,SC方法与相对较少的即时和延迟并发症相关.
■JaiswalP,SainiS,ChhabraPH.锁骨下静脉插管通过锁骨上或锁骨下途径哪个更好?一项前瞻性随机对照试验。印度J暴击护理中心2024;28(4):375-380。
UNASSIGNED: The subclavian vein is frequently cannulated using ultrasound. There are two techniques of subclavian vein catheterization (SVC): Supraclavicular (SC) and
infraclavicular (IC). Though the IC route is often preferred, the SC approach offers several distinct advantages. This
study was planned to compare the technique of SVC using SC and IC approaches in terms of catheterization technique and complications in elective surgeries in adults.
UNASSIGNED: Sixty American Society of Anesthesiologists (ASA) 1, 2, or 3 adult patients posted for elective surgeries under general anesthesia were recruited. Patients were divided into SC or IC groups randomly. Right-sided subclavian vein was cannulated in both the groups (n = 30). Visualization time, Likert scale, subclavian vein diameter, skin-to-subclavian vein depth, number of attempts, puncture time, ease of guidewire insertion, catheter insertion time, and total procedural time were observed. A comparison of complications for each approach was noted.
UNASSIGNED: Total procedural time, time to visualization of the subclavian vein, and puncture time was lower for group SC and higher for group IC. Catheter insertion time was higher with the IC approach than with the SC approach. Better ultrasound view scores were seen in group SC than in group IC. The first attempt success rate was higher in group SC than in group IC. Comparatively, lower complications both during and after the procedure were noted in the SC approach than the IC approach.
UNASSIGNED: Ultrasonography (USG) guidance guided SC approach to access the subclavian vein is quicker, relatively secure, and a better technique than the IC approach. Additionally, the SC approach is associated with comparatively fewer immediate and delayed complications.
UNASSIGNED: Jaiswal P, Saini S, Chhabra PH. Subclavian Vein Cannulation via Supraclavicular or
Infraclavicular Route Which is Better? A Prospective Randomized Controlled
Trial. Indian J Crit Care Med 2024;28(4):375-380.