The Second Try During Landmark Approach of the Internal Jugular Vein: an Ultrasonographic Prelocation Study

Study Overview
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Brief Summary
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Two approaches are possible when the first finder needle attempt of the internal jugular vein cannulation fails; the needle can be turned slightly laterally or the puncture point can be moved slightly medially. This study is an ultrasonographic stimulation study to evaluate the success rate of turning the needle laterally and moving the puncture point medially, and to determine the proper angle or distance for the second try of internal jugular vein cannulation.

Detailed Description
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Immediately after induction of general anesthesia, the patient's head is turned slightly, and the table is tilted at 10 degrees, and the puncture point estimated by the anatomical landmarks are marked on the patient's skin. The investigators obtain a sonographic view at the estimated puncture point. It is recorded success when the internal jugular vein is visualized on the ultrasonography, and the estimated needle path passes the internal jugular vein. It is recorded failure if the internal jugular vein is not visualized on the ultrasonography, and the estimated needle path does not pass the internal jugular vein. After failure of the first attempt, the probe is either turned laterally or moved medially until the internal jugular vein is visualized on the ultrasonography, and the estimated needle path passes the internal jugular vein. The angle and distance is recorded. The location of the carotid artery is always marked on the ultrasonography for evaluation of complications.

Official Title
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The Second Try During Landmark Approach of the Internal Jugular Vein: an Ultrasonographic Prelocation Study

Conditions
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Jugular Veins

Intervention / Treatment
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* Device: Ultrasonography


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients scheduled for general anesthesia Exclusion Criteria: Refusal of consent Patients with C-spine injuries Patients with atlanto-axial instability Patients at risk of increased intracranial pressure

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: IJV_2nd<br>Ultrasonography examination of the patients who are assumed to take second attempt of internal jugular venous catheterization | Device: Ultrasonography<br>* Ultrasonography evaluation of the internal jugular vein.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Success rate of internal jugular vein cannulation at the second attempt after failure of first attempt on ultrasonographic simulation |  | intraoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Degree of lateral rotation or medial movement for successful puncture of second attemp |  | intraoperative |