[Use of new internal jugular vein catheterization modified by using of a "catheter around the needle" (author's transl)].

Anesthesie, analgesie, reanimation Pub Date : 1981-01-01
G Coulombe, J Arrignon, G Oksenhendler, C Winckler
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Abstract

Although widely used, subclavian catheterization has lost popularity to the benefit of internal jugular vein judged more secure. Numerous technics have been described. Since two years we use internal jugular vein catheterization according to the description of Boulanger et al. modified by using a "Catheter around the needle" type device 13 cm long and 1.65 mm wide. 122 patients have experienced 125 catheterizations which were performed on the right side in 96.8 p. cent of the cases. More than 50 p. cent of the patients was conscious at the time of venepuncture. 118 attempts were successful. In 7 cases failure was due either to impossibility of puncture (4 times) or catheterization (3 times). The sole complication was accidental arterial puncture (5 times, 4 p. cent). 4 of them at the time of failure of venepuncture. Training has an important role in the occurrence of failures and complications. They were much more frequent during the twenty first attempts. According to us this technic can reduce incidence of accidental arterial puncture. The risk of pneumothorax is low in spite of the length of the needle. But because of the length and relative stiffness of the catheter the tip is always located in the superior vena cava when the right side has been chosen.

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[使用“针周围导管”改良的新型颈内静脉置管术[作者简介]]。
锁骨下置管虽被广泛应用,但由于颈内静脉置管被认为更安全而失去了知名度。已经描述了许多工艺。两年来,我们根据Boulanger等人的描述使用颈静脉内置管,并使用长13cm,宽1.65 mm的“针周围导管”型装置进行修改。122例患者经历了125次置管,其中96.8%的病例在右侧进行。超过50%的患者在静脉穿刺时是有意识的。118次尝试成功。7例因穿刺失败(4次)或置管失败(3次)。唯一的并发症是意外动脉穿刺(5次,4%)。其中4人在静脉穿刺失败时死亡。培训在失败和并发症的发生中起着重要作用。在第21次尝试中,它们更加频繁。我们认为该技术可以降低意外动脉穿刺的发生率。尽管针的长度不同,气胸的风险很低。但由于导管的长度和相对硬度,当选择右侧时,尖端总是位于上腔静脉。
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