Prospective Randomized Study of Ultrasound Guided In-Plane Versus Out-Of-Plane Radial Artery Cannulation in Adult Cardiac Surgery Patients

Background: With the more frequent use of ultrasound in medical practice, radial artery cannulation using ultrasound has proven to be better than the traditional landmark technique. Ultrasound-guided techniques reduce the risk of cannulation failure and complications like hematoma, arterial spasm, etc. Ultrasound is helpful in obesity, pediatric age group, and hemodynamically unstable patients with a feeble pulse. This study performed a comparison between in-plane and out-of-plane ultrasound-guided techniques for cannulation of the radial artery.
Methodology: This study was prospective randomized and interventional. The study involved adult patients scheduled to undergo cardiac surgery requiring arterial cannulation. Institutional ethics committee approval and consent was taken from the patients. A total of 128 patients were randomized into the in-plane and the out-of-plane ultrasound groups. In the operation room, radial artery cannulation was done under local anesthesia using a hockey stick ultrasound probe. The objective of the study was to compare the incidence of first-pass success rate, the number of attempts, number of redirections, cannulation completion time and incidence of complications in two groups.
Results: The demographic data was found to be comparable. The in-plane group had a higher incidence of first attempt success as compared to the out-of-plane group with a P value of 0.021. There was no statistically significant difference in other clinical outcomes.
Conclusion: The in-plane technique had a higher first-attempt success rate. Hence it should be considered for use in routine practice to improve patient care.