喉罩通气对颈内静脉与颈总动脉解剖关系的影响

Abstract
Figure/Table
References
Related Citation (9)

Download: PDF (526 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To demonstrate the effects of laryngeal mask airway (LMA) placement on anatomic relationship of the internal jugular vein (IJV) with the common carotid artery (CCA) in order to find the optimal approach and avoid inadvertent puncture of the CCA during central venous access. Methods Thirty elective surgical patients requiring LMA general anesthesia were included. The relationship between the IJV and the CCA at two points (the apex of the triangle formed by the sternocleidomastoid muscle and 2 cm above supraclavicular fossa) at 0°, 30°, 60° and maximum head rotation were analyzed by ultrasonography. Results With the increased head rotation, the angle between IJV and CCA became smaller (P<0.05) and the percent overlap of CCA and IJV gradually increased at both sides (P<0.05). At the apex of the sternocleidomastoid triangle, the angle between IJV and CCA decreased and the percent overlap of CCA increased after LMA insertion (P<0.05). There were no statistical differences before and after LMA insertion at the point of 2 cm above supraclavicular fossa at any degree of head rotations (P>0.05). Conclusions Head rotation and LMA placement alter the relationship between the IJV and the CCA. Knowledge of the variation tendency of IJV and CCA anatomy is important information for the operator performing an IJV puncture, to potentially reduce the chance of laceration of the CCA.

Key words： laryngeal mask airway central venous access internal jugular vein common carotid artery ultrasonography

Received: 23 October 2014

ZTFLH:

R323.1

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors

Cite this article:

URL:

http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2015/V26/I2/156

[2]	秦晓辉, 张宏, 米卫东. 不同穿刺点颈内静脉和颈总动脉解剖关系变化的研究[J]. 北京医学, 2013, 35(8):657-660.
[1]	Takeyama K, Kobayashi H, Suzuki T. Optimal puncture site of the right internal jugular vein after laryngeal mask airway placement [J]. Anesthesiology, 2005, 103(6):1136-1141.
[3]	Qin X H, Zhang H, Mi W D. Anatomic relationship of the internal jugular vein and the common carotid artery in Chinese people [J]. Chin Med J, 2010, 123(22):3226-3230.
[2]	秦晓辉, 张宏, 米卫东. 不同穿刺点颈内静脉和颈总动脉解剖关系变化的研究[J]. 北京医学, 2013, 35(8):657-660.
[4]	Rando K, Castelli J, Pratt JP, et al. Ultrasound-guided internal jugular vein catheterization: a randomized controlled trial[J].Heart Lung Vessel, 2014, 6(1):13-23.
[3]	Qin X H, Zhang H, Mi W D. Anatomic relationship of the internal jugular vein and the common carotid artery in Chinese people [J]. Chin Med J, 2010, 123(22):3226-3230.
[5]	Bellazzini M A, Rankin P M, Gangnon R E, et al. Ultrasound validation of maneuvers to increase internal jugular vein cross-sectional area and decrease compressibility[J]. Am J Emerg Med, 2009, 27(4): 454-459.
[4]	Rando K, Castelli J, Pratt JP, et al. Ultrasound-guided internal jugular vein catheterization: a randomized controlled trial[J].Heart Lung Vessel, 2014, 6(1):13-23.
[6]	P Souza, Neto E, Grousson S, et al. Ultrasonographic anatomic variations of the major veins in paediatric patients[J]. Br J Anaesth, 2014, 112(5):879-884.
[5]	Bellazzini M A, Rankin P M, Gangnon R E, et al. Ultrasound validation of maneuvers to increase internal jugular vein cross-sectional area and decrease compressibility[J]. Am J Emerg Med, 2009, 27(4): 454-459.
[7]	Ray B R, Mohan V K, Kashyap L, et al. Internal jugular vein cannulation: A comparison of three techniques [J]. J Anaesthesiol Clin Pharmacol, 2013, 29(3):367-371.
[6]	P Souza, Neto E, Grousson S, et al. Ultrasonographic anatomic variations of the major veins in paediatric patients[J]. Br J Anaesth, 2014, 112(5):879-884.
[8]	Ozbek S, Apiliogullari S, Klvrak A S, et al. Relationship between the right internal jugular vein and carotid artery at ipsilateral head rotation[J]. Ren Fail, 2013, 35(5):761-765.
[9]	王俊安, 汪春英, 陈嘉生. 喉罩通气时超声引导下颈内静脉穿刺的临床有效性分析[J]. 第二军医大学学报, 2011, 32(6):686-687.
[10]	Lorchirachoonkul T, Ti LK, Manohara S, et al. Anatomical variations of the internal jugular vein: implications for successful cannulation and risk of carotid artery puncture [J]. Singapore Med J, 2012, 53(5):325-328.
[7]	Ray B R, Mohan V K, Kashyap L, et al. Internal jugular vein cannulation: A comparison of three techniques [J]. J Anaesthesiol Clin Pharmacol, 2013, 29(3):367-371.
[8]	Ozbek S, Apiliogullari S, Klvrak A S, et al. Relationship between the right internal jugular vein and carotid artery at ipsilateral head rotation[J]. Ren Fail, 2013, 35(5):761-765.
[9]	王俊安, 汪春英, 陈嘉生. 喉罩通气时超声引导下颈内静脉穿刺的临床有效性分析[J]. 第二军医大学学报, 2011, 32(6):686-687.
[10]	Lorchirachoonkul T, Ti LK, Manohara S, et al. Anatomical variations of the internal jugular vein: implications for successful cannulation and risk of carotid artery puncture [J]. Singapore Med J, 2012, 53(5):325-328.