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Optimal shoulder roll height for internal jugular venous cannulation: a study of awake adult volunteers
Wen-Kuei Chang1, Yu-Chieh Wang, Chien-Kun Ting
1Department of Anesthesiology, Taipei Veterans General Hospital, Taipei 112, Taiwan, ROC.
Study Objective:
To explore the influence of shoulder roll height on internal jugular vein (IJV) diameter and IJV/common carotid artery (CCA) overlap.
Design:
Cross-sectional study.
Setting:
University-affiliated hospital.
Patients:
40 healthy participants.
Measurements:
Ultrasonography to measure the effects of using shoulder rolls ranging between 0 and 5 cm high on IJV diameter, CCA diameter, and percentage overlap of the CCA.
Main Results:
The percentage overlap of CCA decreased for both left (LIJV) and right IJV (RIJV) with the use of higher shoulder rolls. Greater values were seen in depth from skin surface to anterior wall of left IJV in almost all stages, with the exception of Stages 0 and 1 (P < 0.016); and the use of a 5 cm shoulder roll resulted in a significantly decreased anteroposterior (AP) diameter of both RIJVs and LIJVs (both P < 0.008).
Conclusions:
Shoulder rolls can reduce the overlap between the IJV and CCA, and may be useful in positioning patients for IJV puncture.
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