Background: Central venous cannulation a vital intervention can be done using numerous approaches for cannulating the internal jugular vein such as anterior, posterior and approach. Of these, the anterior approach is being practised widely, since the identification of landmarks and palpation of carotid artery permits a beginner to learn the procedure easily. The major complications of this approach are carotid artery puncture and hematoma formation. Posterior approach needs identification of only the main bulk of the sternocleidomastoid muscle and external jugular vein, which could be identified even in obese patients easily by the trendelenberg position.
Aim: To evaluate and compare the success rates of anterior and posterior approach for internal jugular vein cannulation.
Material and methods: Hundred patients of American society of Anaesthesiologist (ASA) grade I and II, aged 20-60 years of age were divided into two groups. Group A patients were cannulated by anterior approach while Group-B patients cannulated by posterior approach. Number of attempts, time to identify vein, duration of cannulation, ease of threading and complications like carotid artery puncture, hematoma formation, pneumothorax, hemothorax, thrombophlebitis and catheter displacement were taken into consideration.
Result: The total number of attempts was statistically lower in group B as compared to group A (p value= 0.042). The mean time to identify vein and duration of cannulation was also found to be significantly lower in group B as compared to group A (p value= 0.0043,p value=0.001 respectively). The incidence of carotid artery puncture and hematoma formation was less in group-B as compared to group-A (p value=0.001).
Conclusion: Since Posterior approach for IJV cannulation required lesser number of attempts, less time to identify vein and also less duration of cannulation, It can be considered as a preferred choice for cannulation of internal jugular vein as compared to anterior approach.
