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Indian Journal of Anesthesia and Analgesia

Volume  6, Issue 3, May-June 2019, Pages 937-942
 

Original Article

A Comparative Study of Supraclavicular versus Infraclavicular Approach for Right Subclavian Vein Catheterization

Karthik K1, Anand K2, G. Sivarajan3

1Assistant Professor, 2Associate Professor, 3Professor, Dept of Anaesthesiology, S.R.M. Medical College Hospital and Research Centre, S.R.M. Nagar, Kattankulathur, Tamil Nadu 603203, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6319.35

Abstract

Background and Aim: Supraclavicular approach to subclavian vein catheterization has become one of the forgotten techniques in anaesthesia practice. The aim of this study is to compare supraclavicular approach with infraclavicular approach to subclavian vein cannulation, with respect to time taken to identify and cannulate vein, number of attempts taken to cannulate, success rate and complications. Method: In this study, 60 patients were enrolled and their right subclavian veins were catheterized by either Supraclavicular approach (Group-A, n=30) or infraclavicular approach (Group-B, n=30). Parameters including time to locate the subclavian vein, number of attempts needed to successfully cannulate the vein, success rate, total access time and complications were recorded. Results: The mean time to identify Right Subclavican Vein in first attempt in Group A was 10.652 ± 3.926 seconds as compared to 15.550 ± 8.325 seconds in Group B. In Group A, 23 out of 30 patients (76.7%) were successful in first attempt compared to 20 out of 30 patients (66.7%) in Group B. The average number of attempts needed to successfully identify the right subclavian vein in Group-A was 1.24 ± 0.511 and in Group-B was 1.37 ± 0.688. The total access time for Group A was 197.069 ± 35.12 seconds and for Group B was 227.481 ± 61.22 seconds. Arterial puncture is more common in Group-A (3 out of 30) whereas malposition of the catheter was more common in Group-B (3 out of 30). Conclusion: Supraclavicular approach can be used as an effective alternate to infraclavicular approach for Subclavian Vein cannulation


Keywords : Central Venous Cannulation; Subclavican vein; Supraclavicular approach; Infraclavicular approach.
Corresponding Author : Anand K