An interventional study of Ultrasound guided arterial cannulation and Palpation guided arterial cannulation in Perioperative/Postoperative Complications, sponsored by Queen Mary University of London. Terminated at 1 site in United Kingdom. Open to participants aged 45 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-08-15.
Sponsored by Queen Mary University of London · Not applicable, Interventional, and Treatment
A drop in blood pressure during anaesthesia for a surgical procedure has been associated with worse patient outcomes, including complications such as damage to the heart, brain and kidneys. Continuous blood pressure monitoring prior to the start of anaesthesia alerts the anaesthetist to drops in blood pressure and allows this to be treated promptly. This may help to avoid the complications described above.
Continuous blood pressure monitoring is carried out by inserting a small plastic tube (cannula) into an artery. In this study, the investigators propose inserting a cannula into the radial artery in the wrist before a patient is anaesthetised for surgery. The usual technique for insertion of this cannula is for the anaesthetist to identify the site of the radial artery by feeling for an arterial pulse with the fingertips (palpation). An alternative technique for identification is to use ultrasound. Ultrasound creates a two-dimensional image of the area under the skin on a screen, enabling the operator to visualise the artery being targeted. This may reduce the number of cannulation attempts required, reducing patient discomfort.
The investigators will test whether ultrasound guidance improves the success rate of radial artery cannulation, compared to palpation alone, in a randomised controlled trial in an NHS hospital. Patients will be over 45 years old, undergoing general or neuraxial anaesthesia for non-cardiac surgery lasting 120 minutes or more. Patients will be randomly assigned to a palpation or ultrasound-guided technique for arterial cannulation. Patients will receive numbing local anaesthetic cream to the area beforehand. A needle is used to introduce the cannula into the artery. There will be a maximum of one attempt allowed. In addition to measuring success rate, we will also compare whether the successfully sited cannula provides an adequate arterial waveform, requires resiting at any point during the surgery and any complications which arise directly related to arterial catheterisation. Patients will receive standard anaesthetic and surgical care in all other respects.
1,233 studies on the registry are indexed under Postoperative Complications; 292 are open to participants now.
This study's enrollment of 57 is below the median of 119 across 689 interventional studies indexed under Postoperative Complications.
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Exclusion Criteria:
Anaesthetist will use real-time ultrasound guidance to guide arterial cannulation
Procedure: Ultrasound guided arterial cannulation
Anaesthetist will use palpation (standard-of-care) technique to guide arterial cannulation
Procedure: Palpation guided arterial cannulation
Arterial cannulation will be attempted at the site of the radial artery of the non-dominant hand, using real-time ultrasound guidance
Arterial cannulation will be attempted at the site of the radial artery of the non-dominant hand, using palpation technique (standard-of-care)
Success rate at first attempt to cannulate the radial artery
Success is defined as radial artery cannulation resulting in a transduced arterial waveform. First attempt is defined as one needle puncture through the skin.
Time frame: 10 minutes
Characteristics of arterial waveform
Assessment for presence of: (1) Dicrotic notch; (2) \>1 oscillation after fast flush; (3) \<3 oscillations after fast flush
Time frame: Within 15 mins of catheterisation.
Complications
Recannulation required before/after surgery, infection, hematoma, thrombus.
Time frame: 24 hours
Plan to share: No
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This study is terminated, as verified in Aug 2024. You cannot join it, but the record below documents what was studied.
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Queen Mary University of London