A Comparative Study of Ultrasound Guided Dynamic Needle Tip Positioning Versus Angle Distance Technique for Radial Artery Cannulation in Adult Patients Planned For Surgery

Aims and Objectives: This study was to ascertain the improvement in success rates of first-attempt cannulation of the radial artery using ultrasound guided dynamic needle tip positioning technique (DNTP) versus angle distance (AD) technique. Material and Methods: A total 70 adult patients scheduled for elective surgery, after written informed consent was enrolled after ethical approval. The patients older than 18 years, ASA grade I-IV and positive modified allen’s test was included. Hemodynamically unstable, patient refusing for study, age less than 18 years, and patients with blocked targeting artery was excluded. Patients was assigned for ultrasound guided dynamic needle tip positioning (DNTP) group and angle distance (AD) group (35 patients in each group) using the sealed-envelope method. The anaesthesiologist who was conduct the cannulation procedure know the allocation of patients. The patients were blinded to the allocation. Results: First-pass success without posterior wall puncture was present 80% in group AD and 48.66% in group DNTP. First-pass success rate was present 62.9% in group AD and 28.6% in group DNTP. 10 min overall success rate was present 97.1% in group AD and 88.6% in group DNTP. Cannulation time was 163.26 second in group AD and 429.31 second in group DNTP. Posterior wall puncture was present 20% in group AD and 51.4% in group DNTP. One puncture was present 62.9% in group AD and 28.6% in group DNTP. Two puncture was present 8.6% in group AD and 48.6% in group DNTP. Three puncture was present 22.9% in group AD and 14.3% in group DNTP. Four puncture was present 5.7% in group AD and 8.6% in group DNTP. 600s was 163.26 second in group AD and 429.31 second in group DNTP. Conclusion: The first-pass success rate, with or without arterial posterior wall puncture was more with AD technique compared to DNTP technique. There were no significant difference in the 10-min overall success rate between the DNTP and AD groups. However, the cannulation time was shorter and the posterior wall puncture rate was lower in the AD group than in the DNTP group. The appropriate technique should be applied depending on the specific clinical situation.