Comparison of Effects of Guidewire-Assisted and Direct Arterial Puncture Technique on Success Rate of Radial Artery Cannulation by Inexperienced Trainees

Worapot Apinyachon¹, Natthaporn Boonyakad¹, Inthuon Sangasilpa¹, Phisut Lavanrattanakul¹

Affiliation : ¹ Department of Anesthesiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Background: The radial artery is the preferred site for arterial cannulation. However, cannulation is sometimes difficult and requires multiple attempts, especially by inexperienced trainees. Guidewire-assisted cannulation (GW) is a simple and effective technique, but this maneuver requires practice.
Objective: To compare the effects of a direct arterial puncture (DP) and a GW technique on the success rate of radial artery cannulation by inexperienced trainees.
Materials and Methods: The present study was a prospective cohort study. Sixty patients with the American Society of Anesthesiologists physical status of I to III that underwent elective surgery requiring radial artery cannulation were included in this study. In the GW group, thirty radial artery cannulations were performed by inexperienced surgical residents using a GW technique. In the DP group, 30 patients underwent radial artery cannulation with a DP technique by inexperienced anesthesiology residents. The primary outcome was the success rate of radial artery cannulation.
Results: There were no differences in the baseline blood pressure or comorbidities between the two groups. Overall, the success rate of radial artery cannulation in the GW and DP groups were 90% and 50%, respectively (p=0.001). The success rate of first-attempt cannulation in the GW and DP group were 66.7% and 26.7%, respectively (p=0.002). The total procedural performance time was significantly shorter in the GW than DP group.
Conclusion: The GW technique achieved a higher success rate than the DP technique when performed by inexperienced trainees.

Received 21 November 2021 | Revised 17 January 2022 | Accepted 17 January 2022
DOI: 10.35755/jmedassocthai.2022.02.13265

Keywords : Blood Pressure; Catheterization peripheral/methods; Catheterization peripheral/adverse effects; Internship and residency; Radial artery; Training support

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