A Comparative Study of the Feasibility of External Jugular Vein Cannulations versus Internal Jugular Vein Cannulations in Patients Undergoing Elective Surgical Procedures

• Main Authors: Zulfiqar Ali, Abdul Waheed Mir, Shahid Ahmad Mir, Nelofar Hassan, Abrar Ahad Wani
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2020-04-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: central venous cannulation; complications; seldinger technique
• Online Access: https://jcdr.net/articles/PDF/13631/44085_CE[Ra1]_F(KM)_PF1(AG_KM)_PFA(KM)_PB(AG_KM)_PN(SL).pdf

Introduction: The Internal Jugular Vein (IJV) and subclavian vein cannulations are mainly performed in daily clinical practice. Although success rates for IJV and subclavian veins are high, still the complications are not infrequent. The External Jugular Vein (EJV) approach to the subclavian vein is less taught and less practiced. The fear of frequent failures has discouraged the practitioners from using this approach. Aim: To compare the success rate, number of attempts, and complications associated with IJV and EJV catheterisations. Materials and Methods: A total of 160 patients, requiring central venous catheterisation for various surgical procedures were randomly divided into two groups. Patients in group I (n=80) underwent right IJV catheterisation and patients in group E (n=80) underwent right EJV catheterisation. The number of attempts for cannulation, success or failure of catheterisation and any complications associated with the procedure or in the post-operative period were noted in each group. The data was compared between the two groups by using Chi-square test and Student’s Independent samples t-test. Results: The right IJV was successfully cannulated in 90% while as the right EJV was successfully cannulated in 70% of the patients (p≤0.05). All cannulations were done by the same anaesthesiologist. Malpositioning of catheter was noted in eight patients in Group E while five patients had malpositions in Group I. Pneumothorax was encountered in two patients, and carotid artery puncture in three patients from group I. Conclusion: The rate of success for IJV was better than the EJV. The complication rate of pneumothorax and carotid artery injury was more with IJV than EJV.