title: Ultrasound guided internal jugular venous cannulation: comparison with land-mark technique.
abstract: OBJECTIVE
  To compare real-time ultrasonography-guided technique versus the traditional land-mark technique for internal Jugular venous cannulation.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Department of Anaesthesia, Combined Military Hospital, Rawalpindi, from September 2013 to July 2014.
  
  
  METHODS
  A total of 200 patients who required internal jugular vein cannulation were randomly assigned using either real-time ultrasound-guided technique or land-mark technique. Access time, number of attempts until successful cannulation, complications and the demographics of each patient were recorded.
  
  
  RESULTS
  Access time was significantly less in real-time ultrasound group (34.95 ± 11.47 vs. 146.59 ± 40.20 seconds, p < 0.001). Cannulation was performed in first attempt in 99% of patients in ultrasound group as compared to 89% of landmark group. Complication rate was significantly higher in the land-mark group than in the ultrasound-guided group. Carotid artery puncture rate (9% vs. 1%) and haematoma formation (7% vs. 0%) were more frequent in the land-mark group than in the ultrasound-guided group. Brachial plexus irritation was also more in land-mark group (6% vs. 0%).
  
  
  CONCLUSIONS
  Access time, failure rate and procedure related complications are reduced when real-time ultrasonography is used to cannulate internal Jugular vein.
authors.affiliation: Department of Anaesthesia, Combined Military Hospital, Rawalpindi.
authors.forename: Azmat
authors.initials: A
authors.lastname: Riaz
authors.affiliation: Department of Anaesthesia, Combined Military Hospital, Rawalpindi.
authors.forename: Rao Ali
authors.initials: RA
authors.lastname: Shan Khan
authors.affiliation: Department of Anaesthesia, Combined Military Hospital, Rawalpindi.
authors.forename: Faisal
authors.initials: F
authors.lastname: Salim
mesh_terms: D000328:Adult; D000776:Anesthesiology / Q000379:methods; D006348:Cardiac Surgical Procedures / Q000379:methods; D020212:Carotid Artery Injuries; D002405:Catheterization, Central Venous / Q000379:methods*; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011677:Punctures; D013997:Time Factors; D018084:Ultrasonography, Interventional / Q000379:methods*