Comparison of ultrasound-guided and palpation-inserted peripheral venous cannula in -patients before primary hip or knee arthroplasty: study protocol for a randomized controlled trial.

Autor: Hlasny J; Department of Anaesthesia and Intensive Care, Slovak Medical University, F. D. Roosevelt University Hospital, Banska Bystrica, Slovakia. hlasny.jakub@gmail.com., Alberty R; Department of Biology & Ecology, Faculty of Natural Sciences, Matej Bel University, Banska Bystrica, Slovakia., Hlavac M; Orthopedic Department, Slovak Medical University, F. D. Roosevelt University Hospital, Banska Bystrica, Slovakia., Grgac I; Institute of Anatomy, Faculty of Medicine, Comenius University Bratislava, Bratislava, Slovakia., Grey MT; Department of Anaesthesia and Intensive Care, Slovak Medical University, F. D. Roosevelt University Hospital, Banska Bystrica, Slovakia., Venglarcik M; Department of Anaesthesia and Intensive Care, Slovak Medical University, F. D. Roosevelt University Hospital, Banska Bystrica, Slovakia.
Jazyk: angličtina
Zdroj: Trials [Trials] 2023 Jul 21; Vol. 24 (1), pp. 467. Date of Electronic Publication: 2023 Jul 21.
DOI: 10.1186/s13063-023-07459-x
Abstrakt: Background: More than 2 billion peripheral vascular cannulas are introduced globally each year. It is the most frequently performed invasive procedure in medicine worldwide. There is a group of patients with difficult intravenous access (DIVA). In experts' hands, ultrasound-guided vascular access appears to be a significantly better method. Investigators hypothesize that UGVA is superior also in short-term patency of cannula and even for blood draw through cannula. Repeated cannula pricks in the operating room setting not only puts a lot of stress on the patient and medical staff, but they also waste OR time.
Methods: This investigator-initiated prospective randomized monocentric controlled trial is designed to randomly allocate 200 patients undergoing elective primary total joint arthroplasty of hip or knee to one of two groups as follows: Group C (control group) - peripheral venous cannula insertion by palpation or Group USG (intervention) - cannula insertion by ultrasound-guided vascular access. Our primary endpoint is to compare the number of attempts for ultrasound-guided insertion of the peripheral venous cannula with common palpation insertion of the peripheral venous cannula in overweight/obese patients (BMI ≥ 25). The secondary endpoint is a failure rate of the peripheral venous cannula to administer intravenous therapy up to 5 days postoperatively. Tertiary endpoints include a portion of long PVCs that are able to ensure blood draw up to 5 days postoperatively, time needed to insert PVC in each group, number of needle tip redirections in both groups, and reinsertion of PVC needed in both groups for any reason.
Discussion: This study is pragmatic and is looking for clinically relevant data. After completion, it will answer the question of whether it is clinically relevant to use ultrasound-guided vascular access in the context of not only short-term benefit of insertion, but also up to 5 days after insertion. Also, if this method can ensure blood draw through a peripheral vein cannula, it can save resources in the perioperative period - valuable especially considering the ongoing shortage of medical staff worldwide. If this hypothesis is confirmed, this finding could contribute to more widespread implementation of ultrasound-guided peripheral vascular access in the perioperative period.
Trial Registration: ClinicalTrials.gov NCT05156008. Registered on 13.12.2021.
(© 2023. The Author(s).)
Databáze: MEDLINE
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