Abstract:
BACKGROUND AND OBJECTIVE:For cannulation of the internal jugular vein (IJV), ultrasound increases the number of first pass successes and reduces the rate of mechanical complications. A frequent complication of IJV access is the accidental injury of the common carotid artery (CCA), which can be dangerous in some circumstances. Landmarks and palpation of the CCA are used when ultrasound is not available. These conventional methods are based on the lateral position of the IJV to the CCA, and physicians traditionally employ head rotation to increase the success rates of IJV cannulation. Ultrasound scanning strictly from the anterior to posterior is not possible for this process because the probe must be adequately coupled to compensate for the curvature of the neck. Scans have been performed from different angles lateral to the neck, but misleadingly depict the relationship of the IJV to the CCA. In this study, the authors examined the effect of scanning at a 45° angle at the level of the cricoid on the depiction of the IJV in relation to the CCA. Furthermore, the influence of 30° head rotation to the contralateral side was also investigated. METHOD:The relationship of the IJV to the CCA was recorded using ultrasound in 600 patients. Patients were placed in a supine position and the probe was coupled at the level of the cricoid, scanning at an angle of 45° from the lateral side of the neck. Based on the ultrasound images, the position of the IJV in relation to the CCA was recorded using a segmented grid. The centre of the vein (cross-section of the vertical and longitudinal diameter) determined the segment classification, in which the top of the ultrasound image was defined as the anterior. Additionally, in 300 patients, the head was rotated to the contralateral side at 30° to examine the impact of head rotation on the position of the IJV. RESULTS:The IJV was found in the lateral segment in only 3.0-3.3% of the patients. It was found in the anteromedial segment more frequently on the left side compared to the right side (P < 0.005). On the right side, the IJV was shown more frequently in the anterolateral position (P < 0.0001). Head rotation at 30° in 300 of the 600 patients caused a significant change of the IJV position in the left anteromedial segment, in that it frequently placed the IJV towards the anterior and anterolateral segment (P < 0.05). There was no significant impact of head rotation on the IJV representation on the right side. Atypical positions of the IJV (posterior, medial or thrombosis) were found in some cases. CONCLUSION:Ultrasound images used for IJV access usually depict the vein as being anterior to the CCA and only to a minor extent in the lateral position. This positioning is important for needle processing in order to avoid accidental arterial puncture and to identify atypical positions of the IJV. To determine the ideal puncture site, images of the neck vessels along their entire pathway should be obtained when using ultrasound for vascular access.
journal_name
Eur J Anaesthesioljournal_title
European journal of anaesthesiologyauthors
Maecken T,Marcon C,Bomas S,Zenz M,Grau Tdoi
10.1097/EJA.0b013e328341a492subject
Has Abstractpub_date
2011-05-01 00:00:00pages
351-5issue
5eissn
0265-0215issn
1365-2346journal_volume
28pub_type
杂志文章abstract::It is assumed that diabetic patients with uraemia have more complications at renal transplantation than those who are not diabetic. We compared the preoperative ECGs, and invasive perioperative haemodynamic and oxygenation parameters in 15 diabetic and 15 non-diabetic uraemic patients undergoing renal transplantation....
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.2000.00760.x
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:When airway management is difficult, various measures can be taken to facilitate tracheal intubation. The Bullard and Airtraq laryngoscopes were developed for this purpose. We hypothesised that the Bullard and Airtraq laryngoscopes would perform better than a conventional laryngoscope in the management of a ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e328354b22c
更新日期:2012-07-01 00:00:00
abstract::The effects of laryngeal lignocaine spray and/or lignocaine jelly as lubricants were studied on the incidence of sore throat, hoarseness, or tracheal irritability as evidenced by either a tendency to cough or frank coughing after intubation with a Sensiv tube (Searle Medical Products). Pressure in the medium-volume, l...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1988-11-01 00:00:00
abstract::Thirty-six children (mean age 2.4 years) premedicated with oral chloral hydrate 70 mg kg-1 and atropine 0.03 mg kg-1 were anaesthetized with either 3.75% isoflurane or 2.5% halothane in 70% nitrous oxide in oxygen. The eyelash reflex disappeared in 39 +/- 7 s (mean +/- SD) with isoflurane and in 56 +/- 16 s with halot...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
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abstract::In a multicentre, randomized, double-blind, placebo-controlled dose-ranging study, 1030 patients undergoing outpatient surgery with general anaesthesia received i.v. dolasetron mesylate (12.5, 25, 50, or 100 mg) or placebo. The principal outcome measure was the proportion of patients who were free of emesis or rescue ...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1046/j.1365-2346.2000.00594.x
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND AND AIM:This study assessed the accuracy of using capnography with a modified, hollow gum elastic bougie in predicting tracheal intubation, and its effectiveness as a method of apnoeic oxygenation. METHODS:Patients were randomly allocated to having the gum elastic bougie inserted, under anaesthesia, in the ...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.0265-0215.2000.00774.x
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Ischaemia/reperfusion injury is a common problem in hepatic surgery. An appreciation of the role of sevoflurane dose in preconditioning and subsequent hepatoprotection against ischaemia/reperfusion injury would be useful. OBJECTIVE:The aim of current study was to investigate the protective effect of sevoflu...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e3283614023
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001387
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/S0265021506001219
更新日期:2007-02-01 00:00:00
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The reliability of the Bispectral Index for evaluating and monitoring the depth of general anaesthesia in children is not as great as for that in adults. Therefore we analysed Bispectral Index performance in children by comparing changes in Bispectral Index values during a standardized and equi...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/S0265021508004845
更新日期:2008-11-01 00:00:00
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
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journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
doi:10.1017/s026502159800009x
更新日期:1998-01-01 00:00:00
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/S0265021506001074
更新日期:2006-10-01 00:00:00
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章
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journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
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更新日期:2010-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The aim of the present study was to determine the dosage of remifentanil that must be added to thiopental 5 mg kg(-1) to provide excellent intubating conditions in 95% of patients. METHODS:Sixty-eight premedicated female American Society of Anesthesiologists class 1 and 2 patients were randoml...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
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abstract:BACKGROUND AND OBJECTIVES:This study compares three modes of patient-controlled epidural analgesia in parturients during labour. METHODS:Eighty-four women were randomized to one of three groups. The epidural solution used in all the three groups was 0.1% bupivacaine with fentanyl 2 microg mL(-1). Patients were able to...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Preoperative anaemia is associated with increased postoperative morbidity and mortality. Patient blood management (PBM) is advocated to improve patient outcomes. OBJECTIVES:NATA, the 'Network for the advancement of patient blood management, haemostasis and thrombosis', initiated a benchmark project with the...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,多中心研究
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更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Control of blood pressure remains a key goal of peri-operative care, because hypotension is associated with adverse outcomes after surgery. OBJECTIVES:We explored whether increased vigilance afforded by intra-arterial blood pressure monitoring may be associated with less morbidity after surgery. DESIGN:A p...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
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journal_title:European journal of anaesthesiology
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abstract:BACKGROUND:Many trauma centres have adopted the administration of fixed ratios of packed red blood cells (PRBCs), platelet concentrates and fresh frozen plasma (FFP) for bleeding patients. However, the haemostatic efficacy of this concept is not well proven. OBJECTIVE:Our objective was to characterise the haemostatic ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
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更新日期:2020-10-01 00:00:00
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journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1997.00201.x
更新日期:1997-09-01 00:00:00
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journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
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更新日期:2002-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Previous studies have shown that L-type voltage-sensitive Ca2+ channel blocking agents increased and the L-type Ca2+ channel activator Bay K 8644 reduced the general anaesthetic potency in animals. As the bispectral index correlates with the depth of sedation, we examined whether L-type Ca2+ ch...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
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更新日期:2003-10-01 00:00:00