title: A randomized study of left versus right internal jugular vein cannulation in adults.
abstract: OBJECTIVE
  To compare the success rate and incidence of complications of right internal jugular vein (RIJV) versus left internal jugular vein (LIJV) cannulation using external landmarks or surface ultrasound guidance.
  
  
  METHODS
  Prospective randomized study.
  
  
  METHODS
  Operating room of a university-affiliated hospital.
  
  
  METHODS
  120 adult patients scheduled for elective abdominal, vascular, or cardiothoracic procedures with general anesthesia and mechanical ventilation in whom central venous cannulation was clinically indicated.
  
  
  METHODS
  Patients were randomized to four groups for RIJV cannulation using the landmark approach (Group 1) or surface ultrasound (Group 2) versus LIJV cannulation with the landmark approach (Group 3) or ultrasound (Group 4).
  
  
  RESULTS
  The data collected included time from first puncture to guidewire insertion, number of attempts, and associated complications. If conversion to the ultrasound technique was required, the number of crossover patients and reasons for failure were recorded. Cannulation of the LIJV was more time consuming; it required more attempts; and it was associated with a greater number of complications when compared to the right side (p < 0.05).
  
  
  CONCLUSIONS
  Left IJV cannulation is more time consuming than RIJV cannulation and is associated with a higher incidence of complications. The use of ultrasound improves success rate and decreases the number of complications during IJV cannulation.
authors.affiliation: Department of Anesthesiology, University of Florida College of Medicine, Gainesville, FL 32610-0254, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Sulek
authors.forename: M L
authors.initials: ML
authors.lastname: Blas
authors.forename: E B
authors.initials: EB
authors.lastname: Lobato
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000768:Anesthesia, General; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D015994:Incidence; D007601:Jugular Veins / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D018084:Ultrasonography, Interventional