Heart Disease Clinical Trial
Official title:
Conventional vs. Ultrasound Guided Arteria Cannulation, With and Without Local Anesthesia
The aim of the project is to compare two methods for arterial cannulation. The traditional method with ultrasound guided cannulation. The investigators goal is to improve this procedure to reduce pain and complications.
The practice of placing vascular catheters is used many times every day at almost every
hospital. It is a safe procedure which generally does not imply problems. Though the
procedural optimum aren't reached. The procedure still fails some times and induce
complications. When the catheter is placed using the traditional method the pulse is
palpated by the operator's fingers. This is only to be done near the hand wrist. In this
position the catheter steadiness is fragile but because the pulse can't be sensed more
proximal the operator is forced to choose this position. This it though a problem that can
be solved by non invasive visualization technology. Ultrasound-guidance for central vascular
access is already well-established. However, in recent years ultrasound-guidance for
peripheral vascular access has gained popularity too. The evidence of multiple studies
demonstrates increased success rate and reduced complication rate with ultrasound compared
to blind landmark technique for vascular catheter placement.
In recent years there have been both procedural technique and technology improvements in the
field of ultrasound. This has led to the improvement of procedural catheterisation
techniques that now can be done by novices with higher attempt success rate than traditional
method. One technique that is gaining success is the short-axis-out-of-plane technique
(SAX-OOP) with dynamic-needle-tip-tracking (DNTT).Using the ultrasound machine the needle
can be placed in a more proximal direction on the forearm and the investigators believe that
by the help of the exposed procedure on the monitor many complications can be reduced.
Hypothesis; Firstly the investigators hypothesize that the pain induced by the conventional
method inclusive preoperational lidocaine injection will be the same or more intense than
using DNTT without local anesthesia. Secondly the investigators hypothesize that the use of
DNTT for the placement of the arterial catheter will decrease the time spend, amount of
complications (hematoma), the number of pricks, the number of utilized catheters compared to
the traditional palpation method. Thirdly the investigators claim that the best anatomical
place to put the catheter isn't always corresponding with the spot chosen by palpation,
which increase the number of failures.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Single Blind (Subject), Primary Purpose: Prevention
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