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.
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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.
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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.
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.
2015, Vol. 26 
