The objective of this prospective, randomised study was to examine the impact of a multi-angle needle guide for ultrasound-guided, in-plane, central venous catheter placement in the subclavian vein. One hundred and sixty patients were randomly allocated to two groups, freehand or needle-guided, and then 159 catheterisations were analysed. Cannulation of the first examined access site was successful in 96.9% of cases with no significant difference between groups. There were three arterial punctures and no other severe injuries. Catheter misplacements did not differ between the groups. Higher success rates within the first and second attempts in the needle-guided group were observed (p=0.041 and p=0.019, respectively). Use of the needle guide reduced the access time from a median (IQR [range]) of 30 (18-76 [6-1409]) s to 16 (10-30 [4-295]) s; p = 0.0001, and increased needle visibility from 31.8% (9.7%-52.2% [0-96.67]) to 86.2% (62.5%-100% [0-100]); p < 0.0001. A multi-angle needle guide significantly improved aligning the needle and ultrasound plane compared with the freehand technique when cannulating the subclavian vein. Use of the guide resulted in faster access times and increased success at the first and second attempts.
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机译：这项前瞻性，随机研究的目的是检查多角度针头引导器对锁骨下静脉中超声引导的平面内中央静脉导管放置的影响。一百六十名患者被随机分为两组，徒手或针刺引导，然后分析了159例导管插入术。 96.9％的病例成功插管了第一个接受检查的部位，两组之间无显着差异。有3次动脉穿刺，无其他严重伤害。两组之间的导管置入没有差异。在针引导组的第一次和第二次尝试中观察到较高的成功率（分别为p = 0.041和p = 0.019）。使用导针器可以将访问时间从30（18-76 [6-1409]）s的中值（IQR [范围]）减少到16（10-30 [4-295]）s。 p = 0.0001，针头可见度从31.8％（9.7％-52.2％[0-96.67]）增加到86.2％（62.5％-100％[0-100]）; p ＜0.0001。与徒手技术相比，多角度针头引导器在锁骨下静脉置管时显着改善了针头和超声平面的对准。使用该指南可缩短访问时间，并在第一次和第二次尝试中增加成功率。
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