Dynamic needle tip positioning in short-axis versus long-axis ultrasound-guided arterial cannulation: a randomised controlled trial.

BACKGROUND: Advancements in ultrasound-guided arterial cannulation (USG-AC) are ongoing, with evidence supporting the clinical efficacy of both short-axis (SA) and long-axis (LA) approaches. The objective was to ascertain the efficacy of dynamic needle tip positioning (DNTP) modification in SA versus LA approaches for USG-AC. METHODS: In this prospective randomised controlled trial, 164 individuals were scheduled for elective surgery requiring AC. Randomisation allocated cases to DNTP, which were received as either SA or LA. The procedure involved precise patient positioning, sterile technique, and USG. RESULTS: SA group demonstrated significantly shorter US location times (6.16 ± 1.99 vs. 13.65 ± 3.71 s, p < 0.001) and cannulation times (10.41 ± 3.25 vs. 29.41 ± 5.27 s, p < 0.001) compared to LA group. First-pass success rates were higher in the SA group (92.68% vs. 80.49%, p = 0.022). Complication rates were comparable between groups, with no thrombosis or nerve injury cases. Operator satisfaction was notably greater in the SA group (p = 0.007) than in the LA group. CONCLUSIONS: With DNTP modification, the SA approach demonstrates superior efficacy and success rates than the LA approach for USG-AC while maintaining comparable safety profiles and higher operator satisfaction. TRIAL REGISTRATION: registering on ClinicalTrials.gov (ID: NCT06422195) URL: https://clinicaltrials.gov/study/NCT06422195?cond=NCT06422195&rank=1 (Date: 2024-05-20).