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Canadian Journal of Anesthesia 48:936-937 (2001)
© Canadian Anesthesiologists' Society, 2001

Correspondence

Gauging the depth of venipuncture during internal jugular vein cannulation

Chandra Kant Pandey, MD, Neeta Bose, MD and Garima Garg, MD

Lucknow, India

To the Editor:

Right internal jugular vein (IJV) is the preferred site for central venous cannulation. During the procedure there are chances of complications like arterial puncture, hematoma formation, pneumothorax, thoracic duct injury, arteiovenous fistula, and brachial plexus injury due to the inability to judge the appropriate length that the large bore needle traverses in order to do the venipuncture.1 Complications can be life threatening and may be avoided if the depth from skin to vein is measurable.

In an attempt of safer and accurate cannulation of IJV, we devised a venipuncture and a 24-gauge guide puncture needle with centimetre-highlighted markings (FigureGo). The guide puncture determines the direction of IJV and centimetre markings on it give the exact distance at which IJV is hit. Then the venipuncture needle is introduced in the same direction as the guide puncture needle. As the distance from skin entry to the IJV is measured on the guide puncture needle, the venipuncture needle is introduced to the prefixed distance to hit the IJV.



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  		FIGURE

 
We performed 25 IJV cannulations using this set of needles. In all 25 patients, the venipuncture needle reached the IJV in the first attempt without complications. Though our experience with this needle is limited , we suggest that the use of these needles with markings decrease the complications and increase the chances of accurate and safe placement of IJV catheters.

Reference

1 Khatri VP, Espinosa MH. A safer technique of internal jugular venipuncture: experience with 320 cases. J Cardiothorac Vasc Anesth 1994; 8: 663–7.[Medline]





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