Influence of arm position on ultrasound-guided subclavian vein in-plane puncture and catheterization / 复旦学报（医学版）

ABSTRACT

Objective To investigate the influence of arm position on ultrasound-guided subclavian vein puncture and placement.Methods A total of 90 patients undergoing general anesthesia in Qingpu Branch of Zhongshan Hospital,Fudan University from Aug to Dec 2021 were randomly divided into abduction group(n=45)and adduction group(n=45).The central venous catheter was placed in the plane of subclavian vein under real-time ultrasound guidance.The one-time success rate of puncture,total success rate of puncture and puncture complications of the two groups were observed and recorded.Results In the process of real-time ultrasound-guided subclavian vein puncture,the success rate of one-time puncture in abduction group was 88.9%(40/45),which was significantly higher than that in adduction group(68.9%,31/45),the difference was statistically significant(P=0.020).The total success rate of puncture was 95.6%(43/45)in abduction group and 82.2%(37/45)in adduction group,and the difference was statistically significant(P=0.044).In terms of puncture complications,there were 8 cases of puncture failure in adduction group,including 2 cases of local hematoma,and there were 2 cases of puncture failure in abduction group without local hematoma.No pneumothorax occurred in the two groups,and all the failed cases were replaced by ipsilateral internal jugular vein puncture.Conclusion In patients undergoing general anesthesia,90° arm abduction is convenient for real-time ultrasound-guided subclavian vein puncture and catheterization,which is worthy of clinical promotion.