Comparison of Effects of Guidewire-Assisted and Direct Arterial Puncture Techniques on Success Rate of Radial Artery Cannulation by Inexperienced Trainees
Abstract Background: The radial artery is superficially palpable and easily accessible, making it the preferred site for arterial cannulation. Various placement techniques are available for radial artery catheter insertion. However, catheter insertion is sometimes difficult and requires multiple attempts, especially by inexperienced trainees, leading to technical failure and insertion-related complications. Guidewire-assisted cannulation is a simple and effective technique, but this maneuver requires practice. The main objective of this study was to compare the effects of a direct arterial puncture and a guidewire-assisted cannulation technique on the success rate of radial artery cannulation by inexperienced trainees.Methods: This study was a prospective, single-center, single-arm clinical trial with a historical control. Sixty patients with an American Society of Anesthesiologists physical status of I to III underwent elective surgery requiring radial artery cannulation. In the guidewire-assisted cannulation group (GW group), thirty radial artery cannulations were performed by inexperienced surgical residents using a guidewire-assisted cannulation technique. In the direct arterial puncture group (DP group), 30 patients underwent radial artery cannulation with a direct arterial puncture technique by inexperienced anesthesiology residents. The primary outcome was the success rate. Results: There were no differences in the baseline blood pressure or comorbidities between the two groups. Overall, the success rate of radial artery cannulation in the GW and DP groups were 90% and 50%, respectively (P = 0.001). The success rate of first-attempt cannulation in the GW and DP group were 66.7% and 26.7%, respectively (P = 0.002). The total procedural performance time was significantly shorter in the GW than DP group.Conclusion: The guidewire-assisted cannulation technique achieved a higher success rate than the direct arterial puncture technique when performed by inexperienced trainees.Trial registrationThe trial was registered on Thai Clinical Trials Registry (TCTR20200601004). Date of registration was January 19, 2020. (Retrospectively registered) http://www.thaiclinicaltrials.org/page_user/#