Source

Department of General Surgery Transplantation, Haydarpasa Numune Training and Research Hospital, Uskudar, Istanbul, Turkey.

Abstract

AIM:

Anatomical landmark technique for central venous catheter insertion preoperatively during renal transplantation may result in serious complications. In this prospective study, we sought to evaluate the results of ultrasonography-guided central venous catheter insertion before renal transplantation.

PATIENTS AND METHODS:

Since March 2004 routine ultrasonography-guided central venous catheter insertion was performed before the operation for living related renal transplantation. Chest X-ray was used as a control after catheter insertion. Visual pain scale was evaluated after the procedure. We recorded the duration of the procedure, amount of local anesthetic, number of punctures, and complications, namely, hematoma, carotid artery puncture, hemorrhage, and hemo-pneumothorax.

RESULTS:

Since March 2004, 120 jugular venous catheters were inserted into renal transplant recipients preoperatively. Mean visual pain scale was 2.5 +/- 1.2 cm (range, 0.6-4.1 cm). Mean duration of the procedure was 9 +/- 3 minutes (range, 6-15 minutes); the amount of local anesthetic injected was 1.6 +/- 0.6 mL (range, 0.9-2.3 mL). There was no carotid artery puncture, hemo-pneumothorax, or hematoma. During the study period, 3 of the first 10 catheter insertions required more than 1 puncture, for the rest 1 puncture was sufficient for catheter insertion. There was no bleeding or intravenous fluid leakage from the catheter insertion site.

CONCLUSION:

Ultrasonography-guided jugular venous catheter insertion is a successful safe method. Routine ultrasonography-guided procedures before renal transplantation avoided the complications related to catheter insertion.