A Difference in Subclavian Vein Catheterization Between Supine and Lateral Tilt Position - Stage II

Study Overview
=================
Brief Summary
-----------------
Central venous catheterization is widely used for various purposes during surgery. For central venous catheterization, subclavian vein is selected because of the relatively low risk of infection, long-term patency and low patient discomfort. The cross - sectional area of the subclavian vein is an important factor to increase success rate. Several studies have reported that the Trendelenburg position increases the cross-sectional area of the subclavian vein, and the lateral tilt position can change the cross-sectional area of the subclavian vein. However, the impact of lateral tilt position to the cross-sectional area of the subclavian vein is not clear. The ipsilateral position can increase the cross-sectional area of the subclavian vein, and the contralateral position can decrease the cross-sectional area by gravity. In the second stage of this study, the investigators would like to compare the success rate, the number of needle passage, time to complete subclavian vein catheterization in supine and ipsilateral tile position.

Official Title
-----------------
A Difference in the Cross-section Area of Subclavian Vein Between Supine and Lateral Tilt Position: Its Clinical Impact on Subclavian Venous Catheterization - Stage II

Conditions
-----------------
Catheterization, Posture

Intervention / Treatment
-----------------
* Procedure: Ipsilateral tilt


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: - the patients who receive elective neurosurgical surgery and require central venous catheter Exclusion Criteria: the patients who have puncture site infection the patients who have chemoport, pacemaker in right subclavian vein the patients who had received right mastectomy or right pneumonectomy other contraindications for subclavian venous catheterization (eg. mass, hematoma, vegetation, and anticoagulation)

Ages Eligible for Study
-----------------
Minimum Age: 20 Years
Maximum Age: 79 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Ipsilateral tilt<br>The operation table will be tilted 20 degrees right laterally before subclavian venous catheterization. | Procedure: Ipsilateral tilt<br>* The operation table will be tilted 20 degrees right laterally.<br>|
| No Intervention: Supine<br>Catheterization of right subclavian vein in supine position. | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The number of needle passage | The number of needle passage for puncture of subclavian vein | during subclavian venous catheterization | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to puncture subclavian vein | Time to puncture subclavian vein | during subclavian venous catheterization | 
| Time to insert guidewire | Time to insert guidewire | during subclavian venous catheterization | 
| Time to insert dilator | Time to insert dilator | during subclavian venous catheterization | 
| The number of trial to insert catheter | The number of trial to insert catheter | during subclavian venous catheterization | 
| Time to insert catheter | Time to insert catheter | during subclavian venous catheterization | 
| Success of catheter insertion | Final success of catheter insertion within 6 trials | during subclavian venous catheterization | 
| Other complications with central venous catheterization | complications with central venous catheterization such as arterial puncture, perivascular hematoma, pneumothorax, and malpositioning | From subclavian venous catheterization to 24 hours after operation finished |