title: Safe and easy method with little modification in technique is useful for successful internal jugular vein cannulation on the same side even after intra-arterial puncture without using ultrasound guidance in adult cardiac patients.
abstract: BACKGROUND
  The modification in technique is useful for successful right-sided internal jugular vein (IJV) cannulation on the same side even after intra-arterial puncture without using ultrasound guidance in adult patients.
  
  
  METHODS
  This study was carried out in total 160 adult patient from American Society of Anesthesiologists Grade II to III patients male (n = 95) and female (n = 65) who underwent cardiac surgery where cannulation was done on right sided by triple lumen catheter (7 French) using Seldinger technique.
  
  
  RESULTS
  Majority of patients were cannulated successfully by Seldinger technique with single or double attempt except for five patients in which arterial puncture occurred. All five patients were cannulated successfully on the same side with this modified technique without any significant major complications. They were managed by application of blocker at the end of arterial needle puncture without removing it. In our routine practice, we were used to removing this needle and applying compression for few minutes to prevent hematoma formation after an arterial puncture. In this study, cannula was used as a marker or guideline for the relocation of IJV on the same side and recannulation was performed by changing the direction of needle on same side lateral to the previous one and without going towards the same direction to prevent the arterial puncture again.
  
  
  CONCLUSIONS
  Most simple and useful modified technique for institutes where the complications are most common with trainee doctors and in hospitals where there is no advanced facility like ultrasound-guided cannulation available. By this modification, it will be time saving, very comfortable, and user-friendly technique with high success rate.
authors.affiliation: Department of Cardiac Anesthesia, U. N. Mehta Institute of Cardiology and Research Center (Affiliated to B. J. Medical College), Ahmedabad, Gujarat, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Thosani
authors.forename: Jigar
authors.initials: J
authors.lastname: Patel
authors.forename: Hemang
authors.initials: H
authors.lastname: Gandhi
authors.forename: Chirag
authors.initials: C
authors.lastname: Doshi
authors.forename: Jignesh
authors.initials: J
authors.lastname: Kothari
mesh_terms: D000293:Adolescent; D000328:Adult; D001158:Arteries / Q000293:injuries; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006331:Heart Diseases / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007601:Jugular Veins; D008297:Male; D019300:Medical Errors; D008875:Middle Aged; D011446:Prospective Studies; D018084:Ultrasonography, Interventional; D055815:Young Adult