Comparison of pen holding technique with conventional needle holding technique for ultrasound guided internal jugular venous cannulation in ICU patients.

Title :Comparison of pen holding technique with conventional needle holding technique for ultrasound guided internal jugular venous cannulation in ICU patients.

Aim :To compare proximal pen-holding technique with conventional technique to cannulate right internal jugular vein under ultrasound guidance. Primary Objective:

1. To compare time taken for successful guidewire insertion Secondary objectives: 1. To compare number of attempts to localize the vein. 2. To compare ease of procedure. 3. To compare incidence of posterior vessel wall puncture.

4.     To compare incidence of any other complications.

Inclusion criteria: Adult patients aged between 18-60 years, of either sex requiring central venous cannulation admitted in intensive care unit. Exclusion criteria: Patients with Bleeding tendency, Cervical spine disorders, Neck surgery/pathology, Burns patients. Patients on high doses of inotropes/vasopressors, Pregnant females and Unwilling to participate will be excluded. Sample Size: 132 (66 in each arm) Group allocation Patients will be allocated into one of the following groups using computer generated randomization table. Group P (n=66) will be cannulated with proximal pen holding technique. Group C (n=66) will be cannulated with conventional needle holding technique.

Assessment : 1)Time taken for successful guidewire placement in seconds, Number of attempts required to localize the vein,Number of redirections in each attempt, Ease of the procedure, Incidence of  PVWP, Any other complications ,Adverse events and Failure Analysis : Data will be compiled, compared and appropriate statistical test will be applied to analyse the results.