Comparison of Subclavian Vein Catheterization Using Supraclavicular Versus Infraclavicular Approach

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Comparison of Subclavian Vein Catheterization Using Supraclavicular Versus Infraclavicular Approach

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Background: Infraclavicular (IC) approach for Subclavian Vein (SCV) catheterization is widely used compared to Supraclavicular (SC) approach. Recently, SC approach for SCV catheterization has gained prominence because of its well-defined landmarks with more success and less complication rate. The primary aim of this study is to determine whether US guided SC approach or IC, provides the best SCV catheterization and the complications related to either approach. Methodology: A total of 110 patients were randomly divided into two groups of 55 patients each, the SC group (Group S) and IC group (Group I). All SCV catheterization were done by single trained anesthesiologist. The parameters recorded were access time, successful catheterization, number of attempts, catheter insertion time, ease of guide wire insertion and complications. Results: Mean access time in Group S was 32.4s compared to 39.24s in Group I. Successful catheterization and numbers of attempts were better in SC approach. Mean catheterization time was 55.4 ± 3.02s in Group S and 78.3 ± 8.605s in Group I and was significant (p < 0.0001). 96.4% patients in Group S and 92.7% patients in Group I was successfully catheterized and was associated with smooth insertion of guide wire. There were two cases of arterial puncture and one case of hemotoma in Group I as compared to only one case of hemotoma in Group S. Conclusion: SVC cannulation by US guided SC approach is better with respect to IC approach in terms of time for catheterization and complications.

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