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Palpation versus Ultrasound-Guided Dynamic Needle Tip Positioning Technique for Radial Artery Cannulation
Sujan Dhakal1,2,3, Gentle S Shrestha4,5, Ritesh Lamsal2
1Department of Anaesthesiology and Critical Care, Provincial Hospital Bhadrapur (PHB), Nepal.
Annals of Cardiac Anaesthesia
|July 9, 2025
Summary
The ultrasound-guided dynamic needle tip positioning (USG-DNTP) technique significantly improves first-pass success rates for radial artery cannulation compared to the conventional palpation method. This advanced technique also reduces procedure time and the number of attempts needed.
Area of Science:
- Anesthesiology
- Medical Imaging
- Surgical Procedures
Background:
- Invasive blood pressure monitoring is crucial for perioperative patient management.
- Radial artery cannulation is the standard method, but conventional palpation (CP) can be challenging.
- Alternative techniques are needed to improve cannulation success rates.
Purpose of the Study:
- To compare the first-pass success rate of ultrasound-guided dynamic needle tip positioning (USG-DNTP) with the conventional palpation (CP) method for radial artery cannulation.
- To evaluate secondary outcomes including 5-minute success rate, cannulation time, and number of punctures/cannulae used.
Main Methods:
- A randomized study involving 52 adult patients requiring radial artery cannulation.
- Patients were assigned to either the CP method or the USG-DNTP method.
- Statistical analyses included Chi-square, independent sample t-test, and Mann-Whitney U tests.
Main Results:
- The USG-DNTP method demonstrated a significantly higher first-pass success rate (88.5%) compared to CP (46.2%) (P<0.001).
- Overall 5-minute success rates were 96.2% for USG-DNTP versus 65.4% for CP (P<0.005).
- USG-DNTP required less time (median 44s vs 134s) and fewer skin punctures (1.15 vs 2.04) than CP.
Conclusions:
- The USG-guided DNTP technique significantly enhances the first-pass success rate of radial artery cannulation.
- This method offers improved efficiency and reduced complications compared to the conventional palpation technique.
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