The New Position of Radial Artery Puncture and Cannulation of the Patient With Surgery（RAPC-02）
NCT Number: NCT06566456
Status: NOT_YET_RECRUITING
Study Type: INTERVENTIONAL
Phases: NA
Conditions: The New Position of Radial Artery Puncture and Cannulation of the Patient With Surgery
Interventions: PROCEDURE: The puncture site is within 2-4 cm above the second wrist transverse crease|PROCEDURE: The puncture site is within 0-1.9 cm above the second wrist transverse crease
Sponsor: Sixth Affiliated Hospital, Sun Yat-sen University
Sex: ALL
Age: ADULT, OLDER_ADULT
Enrollment: 754
Study Design: Allocation: RANDOMIZED|Intervention Model: PARALLEL|Masking: SINGLE (OUTCOMES_ASSESSOR)|Primary Purpose: PREVENTION
Start Date: 2024-09-01
Completion Date: 2025-05-31
Locations: the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510655, China

Summary:
Invasive arterial blood pressure monitoring is the gold standard for blood pressure monitoring. The radial artery is the most commonly used site of arterial puncture and catheterization. The traditional puncture site is located at 0-1.9cm above the second wrist transverse crease. Due to the large range of motion of the wrist joint, the ductus arteriosus bending, unstable blood pressure waveform, and puncture complications occur. We believe that changing the puncture site is beneficial to enhance the stability of the perioperative arterial catheter, improve the accuracy of blood pressure values, and reduce the puncture-related complications. The purpose of this randomized controlled trial is to study the effect of radial artery puncture 2-4cm above the second wrist transverse crease on perioperative arterial catheter stability, blood pressure numerical accuracy, puncture-related indicators, and complications, using the traditional radial artery puncture site as a control.

Primary Outcome Measures: Incidence of catheter instability, the ratio of the number of cases with catheter instability to the total number of participants in each group.

catheter instability is defined as meeting at least one of the following conditions:

1. Significant improvement in the arterial waveform after rapid flushing (performed every 15 minutes or when the arterial waveform appears flattened
2. Adjustment of the arterial catheter/wrist position is required to obtain a satisfactory arterial waveform;(3)The blood drawing cannot be drawn through the arterial pressure measurement line.), start to the end of the surgery
Secondary Outcome Measures: Frequency of catheter instability, The average number of catheter instability events per hour per participant, from the start to the end of the surgery|The numerical difference between arterial blood pressure and non-invasive blood pressure, the mean arterial pressure difference value before and after rapid flush test, from the start to the end of the surgery|Abnormal rate of damping coefficient, the ratio of the total number of cases with over-damping and under-damping to the total number of participants in each group, from the start to the end of the surgery|First-attempt cannulation success rate, the ratio of the number of successful first-attempt arterial cannulations to the total number of participants in each group, From the start of arterial puncture until successful arterial catheter placement or abandonment of the arterial catheter placement procedure|Number of arterial puncture, the number of attempts at arterial puncture at the assigned puncture site (each re-insertion of the needle into the subcutaneous tissue is counted as one additional puncture, From the start of arterial puncture until successful arterial catheter placement or abandonment of the arterial catheter placement procedure|Puncture duration, the time interval between the first percutaneous puncture to the display of the first arterial blood pressure waveform on the monitor, From the start of arterial puncture until successful arterial catheter placement or abandonment of the arterial catheter placement procedure|Complications, including the incidence of complications during puncture and catheter placement, such as hematoma, bleeding, ecchymosis; and incidence of post-puncture complications, including local bleeding, hematoma, peripheral ischemia, local infection, peripheral nerve injury, and accidental catheter shedding, from the time of the puncture onset until the time of every 24 hours after surgery (at 1-day, 2-day, 3-day|QoR-15 score, covering 5 aspects of 15 subjective parameters, each 0-10 points, a total of 0-150 points, the higher the value, the better the recovery quality, the second and third days after surgery