Doppler-guided cannulation of the internal jugular vein: a prospective, randomized trial

The internal jugular vein (IJ) is commonly used as an access to the central venous system. Despite the high success rate for cannulation of the IJ, the incidence of complications (1% to 16%) has remained essentially the same, with most complications resulting from unintentional punctures of surrounding structures. In an attempt to reduce the complication rate of this technique, we evaluated the use of a Doppler-guided needle device to cannulate the IJ. The study was performed on 41 patients scheduled for cardiothoracic or major vascular surgery requiring central vein cannulation as part of their anesthetic management. The number of needle advances in the Doppler group was 1.35 (SD 0.88) compared with 2.8 (SD 2.78) in the control group (p = 0.037). A significantly greater percentage of cannulations were successful on the first attempt in the Doppler group (85%), compared with the control group (55%) (95% CI for proportion = 0.3 to 0.57). The Doppler-guided cannulation technique can reduce the number of attempts required for successful IJ cannulation.