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Central venous catheterization is widely used for various purposes during surgery. For central venous catheterization, subclavian vein is selected because of the relatively low risk of infection, long-term patency and low patient discomfort. The cross - sectional area of the subclavian vein is an important factor to increase success rate. Several studies have reported that the Trendelenburg position increases the cross-sectional area of the subclavian vein, and the lateral tilt position can change the cross-sectional area of the subclavian vein. However, the impact of lateral tilt position to the cross-sectional area of the subclavian vein is not clear. The ipsilateral position can increase the cross-sectional area of the subclavian vein, and the contralateral position can decrease the cross-sectional area by gravity.
In the second stage of this study, the investigators would like to compare the success rate, the number of needle passage, time to complete subclavian vein catheterization in supine and ipsilateral tile position.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ipsilateral tilt | Experimental | The operation table will be tilted 20 degrees right laterally before subclavian venous catheterization. |
|
| Supine | No Intervention | Catheterization of right subclavian vein in supine position. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ipsilateral tilt | Procedure | The operation table will be tilted 20 degrees right laterally. |
|
| Measure | Description | Time Frame |
|---|---|---|
| The number of needle passage | The number of needle passage for puncture of subclavian vein | during subclavian venous catheterization |
| Measure | Description | Time Frame |
|---|---|---|
| Time to puncture subclavian vein | Time to puncture subclavian vein | during subclavian venous catheterization |
| Time to insert guidewire | Time to insert guidewire |
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Inclusion Criteria:
- the patients who receive elective neurosurgical surgery and require central venous catheter
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Hyung-Chul Lee, MD | Contact | +82-10-2456-6336 | lucid80@gmail.com |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32891115 | Derived | Yoon HK, Lee HC, Kang P, Lee JM, Park HP, Cho YJ. Effects of ipsilateral tilt position on the cross-sectional area of the subclavian vein and the clinical performance of subclavian vein catheterization: a prospective randomized trial. BMC Anesthesiol. 2020 Sep 5;20(1):226. doi: 10.1186/s12871-020-01144-1. | |
| 29793550 | Derived |
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| during subclavian venous catheterization |
| Time to insert dilator | Time to insert dilator | during subclavian venous catheterization |
| The number of trial to insert catheter | The number of trial to insert catheter | during subclavian venous catheterization |
| Time to insert catheter | Time to insert catheter | during subclavian venous catheterization |
| Success of catheter insertion | Final success of catheter insertion within 6 trials | during subclavian venous catheterization |
| Other complications with central venous catheterization | complications with central venous catheterization such as arterial puncture, perivascular hematoma, pneumothorax, and malpositioning | From subclavian venous catheterization to 24 hours after operation finished |
| Jung DE, Lee HC, Yoon HK, Park HP. The effects of ipsilateral tilt position on right subclavian venous catheterization: study protocol for a prospective randomized trial. Trials. 2018 May 24;19(1):292. doi: 10.1186/s13063-018-2666-8. |