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Radial cannulation is needed in perioperative management of many patients requiring invasive hemodynamic monitoring during surgery and may be not only time consuming and at times difficult to attain in untrained centers. Objectives: Comparative evaluation of safety and efficacy of Radial Arterial Cannulation using Conventional blind palpation technique with Ultrasound guided Technique perioperatively – Raccuet Study. Materials and Methods: This randomized controlled, prospective, single blind comparative study was conducted on 142 adult ASA I to IV patients of either sex, scheduled for elective major surgery requiring general anesthesia of which 71 patients underwent radial cannulation by classical palpatory method (group P) and the other 71 underwent radial cannulation under ultrasound guidance (Group U). All procedures were evaluated using Siemens Acuson X500 ultrasound machine with 5-13Hz linear array transducer. All patients were evaluated for efficacy by measuring time to cannulation (TTC), mean time to first attempt cannulation (mTFA), and number of attempts for cannulation (NA). Safety was assessed by evaluating incidence of hematoma and spasm in both the groups. Statistical analysis was done using (SPSS) Version 22.0. Independent t test and Mann Whitney test have been used for carrying out significant P value. Results: Patients were demographically similar in both the groups. TTC in group U (37.97±18.14sec) was significantly less than that in Group P (58.38±21.45sec) (P =0.007).mTFA was 34.81±15.77 seconds in group U compared with 55.58±19.29 seconds with group P (P=0.01). There was trend towards lower NA in group U as compared to group P (P=0.06).Incidence of hematoma formation and vasospasm were similar amongst both groups but study was underpowered to evaluate the same. Conclusion: Ultrasound guided radial artery cannulation improves the success rate of cannulation in lesser time with similar complication rates as compared to classical palpatory method of cannulation. Introduction Continuous blood pressure monitoring via radial artery cannulation along with easy access for blood sampling can provide the clinician with vital information in the perioperative period. The consistent anatomic accessibility, ease of cannulation and a low rate of complications make the radial artery the preferred site for arterial cannulation. Indications for arterial cannulation include continuous bloodpressure monitoring, frequent arterial blood-gas analysis, repeated blood sampling for laboratory evaluation. Traditionally, radial artery cannulation has been performed using anatomic knowledge and pulse palpation as a guide to placement. However, patients requiring arterial lines may be hypotensive or obese, resulting in difficult palpation of the pulse and also the catheter may not be passed successfully into the artery, despite apparent good blood return on initial puncture, or the artery may develop spasm after a failed attempt, thus making any further attempts more difficult. Ultrasound (US) is being used with increasing frequency as an adjunct in vascular access. Numerous studies have shown that US guidance for central venous access provides significant benefits over the traditional external landmark technique but little has been published on the use of US guidance for radial artery catheter placement. Despite increased access to ultrasound machines, fewer clinicians are familiar with ultrasound-guided techniques of arterial catheterization. Ultrasound-guided arterial catheterization can be easily learned if the operator has familiarity with other ultrasound-guided procedures. We sought to evaluate the application of US guidance to radial-arterial cannulation to determine whether it offers advantages over the traditional palpation technique or not. The efficacy primary end point of the study was defined as measuring time to cannulation (TTC), mean time to first Article Info Received: 8th May, 2019 Accepted: 22nd May, 2019 Published Online: 22nd August, 2019

indian journal of clinical anaesthesia

Comparative evaluation of safety and efficacy of radial arterial cannulation using conventional blind palpation technique with ultrasound guided Technique perioperatively - Raccuet study