Peripheral Venous Catheterization
Conditions
Keywords
Ultrasound-Guided Peripheral Intravenous Cannulation, Short-Axis Out-of-Plane Approach, Long-Axis In-Plane Approach, Peripheral Intravenous Access, Interventional Ultrasonography
Brief summary
This randomized study compared two ultrasound-guided techniques for placing a peripheral intravenous cannula in adults aged 20 to 60 years who required intravenous access. Participants were assigned equally to either the short-axis out-of-plane approach or the long-axis in-plane approach. The study evaluated whether the techniques differed in successful cannulation. It also compared cannulation time, number of attempts, and immediate complications, including arterial puncture, extravasation, and haematoma.
Detailed description
This single-centre, parallel-group randomized controlled trial was conducted in the Department of Anaesthesiology at Medical Teaching Institution-Lady Reading Hospital, Peshawar, Pakistan. A total of 222 eligible adults requiring peripheral intravenous access were enrolled through consecutive sampling. Participants were randomized in a 1:1 ratio using a computer-generated sequence. In the short-axis group, the ultrasound probe was positioned perpendicular to the target vein to obtain a transverse image, and the needle was advanced using an out-of-plane technique. In the long-axis group, the probe was positioned parallel to the vein to obtain a longitudinal image, and the needle was advanced in plane while maintaining visualization of the needle tip. Experienced anaesthesiologists performed all procedures. Cannulation was considered successful when the catheter advanced without resistance, blood returned freely into the hub, and saline could be flushed without local swelling. The primary outcome was successful peripheral intravenous cannulation. Secondary outcomes included cannulation time, number of attempts, and immediate complications comprising arterial puncture, extravasation, and haematoma. No delayed follow-up outcomes were assessed.
Interventions
PROCEDUREShort-Axis Out-of-Plane Ultrasound-Guided Cannulation
The ultrasound probe was positioned perpendicular to the target vein to obtain a transverse image. A peripheral intravenous cannula was inserted by advancing the needle using the out-of-plane technique under real-time ultrasound guidance.
PROCEDURELong-Axis In-Plane Ultrasound-Guided Cannulation
The ultrasound probe was positioned parallel to the target vein to obtain a longitudinal image. A peripheral intravenous cannula was inserted by advancing the needle in plane while maintaining visualization of the needle tip under real-time ultrasound guidance.
Sponsors
Lady Reading Hospital, Pakistan
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Participants were randomly assigned in a 1:1 ratio to one of two parallel groups. One group received ultrasound-guided peripheral intravenous cannulation using the short-axis out-of-plane approach, while the other received the long-axis in-plane approach. Each group included 111 participants.
Eligibility
Sex/Gender
ALL
Age
20 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Men and women aged 20 to 60 years * Required peripheral intravenous access
Exclusion criteria
* Body mass index of 30 kg/m² or greater * Infection at the intended cannulation site * Upper-limb deformity * Previous venous thrombosis * Refusal to participate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Successful Peripheral Intravenous Cannulation | Immediately following the assigned cannulation procedure | Cannulation was considered successful when the catheter advanced without resistance, blood returned freely into the hub, and saline could be flushed without local swelling. The outcome was recorded as successful or unsuccessful. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cannulation Time | uring the assigned cannulation procedure | Time required to achieve successful peripheral intravenous cannulation, measured in seconds. |
Countries
Pakistan
Outcome results
None listed