Comparison of direct and guide-wire assisted techniques of radial artery cannulation in patients posted for emergency surgery- a randomized clinical trial.

Invasive arterial pressuremonitoring and frequent blood gas analysis have become essential components forphysiologic optimization and anesthesia management of emergency surgical proceduresin patients presenting with major blood loss or sepsis. Radial artery is usedcommonly for cannulation as it is easily accessible and associated with lessincidence of post-cannulation complications (1). Various techniques exist forarterial cannulation like the direct over-the-needle cannulation(2,3,4),guide-wire assisted catheterization(2,3,4), liquid stylet technique(5), andultrasound-guided catheterization(6).

Previous studies have shown thatradial artery cannulation with guide-wire assistance was more successfulcompared to the direct technique in patients undergoing various cardiovascularand neurosurgical procedures in the elective set-up, done by staff anesthesiologists(3, 4). In the emergency surgical suite the arterial cannulations are mostly doneby residents with limited experience and the direct cannulation is the mostcommon technique employed. However the direct cannulation technique may bedifficult in patients with low arterial pressure, requiring multiple attemptsand causing considerable delay. The purpose of this study is to assess whether arterialcannulation can be achieved faster, with fewer attempts, using the guide-wireassisted technique.