Anesthesia, Children, Only
Conditions
Keywords
Pediatrics, Anesthesiology, Cannula, Anesthesia, Intravenous, Catheterization
Brief summary
The investigators hypothesize peripheral intravenous cannulation (insertion of tube into vein) will be facilitated (decreases the number of attempts) by a passive leg raise (raising the legs at the hip to 45 degree in a child laying on their back) in children.
Detailed description
Establishing peripheral intravenous (PIV) access in the pediatric population is challenging even in the hands of skilled practitioners. A passive leg raise (PLR), raising a patient's legs to a 45 degree angle while supine, auto-transfuses the blood volume within the patient's lower extremities into the central venous compartment. Increasing the blood volume in the central venous compartment may also increase the volume and caliber of upper extremity peripheral veins. It remains to be studied whether a PLR increases peripheral vein diameter and if this would facilitate the placement of PIVs in the pediatric population.
Interventions
PROCEDUREPassive Leg Raise
A passive leg raise (PLR) is defined as raising a patient's legs to a 45-degree angle at the hip while supine.
Sponsors
University of Saskatchewan
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
The investigators propose a prospective, parallel group, open-label randomized controlled trial.
Eligibility
Sex/Gender
ALL
Age
3 Months to 17 Years
Healthy volunteers
Yes
Inclusion criteria
* Children ages 3 months to 17 years. * American Society of Anesthesiology (ASA) physical status 1-3 scheduled for elective surgical procedures under general anesthesia.
Exclusion criteria
* Children undergoing procedures who already have adequate IV access (ie pre-established central or peripheral access). * Those greater than the age of 17, as this is the age limit for care at the Jim Pattison Children's Hospital. * Those with any lower limb pathology that limits range of motion.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The number of attempts to successful catheterization. | During the intraoperative procedure. | The study's primary outcome (number of peripheral IV attempts) will be analyzed using a Chi-square test. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The mean change in peripheral vein diameter following passive leg raise, assessed on ultrasonography. | During the intraoperative procedure. | The change, if any, in peripheral vein diameter will be measured by comparing the diameter assessed by ultrasound at baseline and following leg raise. Results will be compared using the student's t test. |
| Time from skin puncture to the confirmation of a functioning peripheral line. | Measured intraoperatively, an expected estimated average of 2 minutes. | Time to vein cannulation will be compared using the student's t test. |
| Provider perception of PLR on vein visualization. | Immediately following successful cannulation in the experimental group. | Chi-square testing will be used to evaluate provider perception of passive leg raise on vein visualization and palpation. |
| Provider perception of PLR on vein palpation. | Immediately following successful cannulation in the experimental group. | Chi-square testing will be used to evaluate provider perception of passive leg raise on vein visualization and palpation. |
Countries
Canada
Outcome results
None listed