Effect of arterial blood FLOW measured by ultrasonography on radial arterycatheterization

Purpose: In this study, the effect of arterial catheterization on first pass success, catheterization time and skin perforation number was investigated by making radial arterial flow measurements with USG in patients scheduled for invasive arterial monitoring after general and local anesthesia. Method: Study; Patients who were deemed suitable for invasive arterial monitoring by the anesthesiologist and whose catheterization was performed under USG guidance were included. Patients included in the study were divided into post-local anesthesia arterial cannulation group (Group L) and post-induction arterial cannulation group (Group G). The demographic characteristics, vital signs, and radial artery flow and diameters before catheterization were recorded, and the success of the first passage to the radial artery, the number of catheters used, the number of skin perforations, and the time to reach successful cannulation (seconds) were evaluated. Results: Systolic blood pressures, diastolic blood pressures, mean arterial pressures and SPO2 values during cannulation of Group L were found to be higher than Group G (p<0.001). There was no significant difference in arterial diameters between the two groups (p:0.872; p:0.239). Flow parameters were found to be higher in Group L (p<0.001; p:0.003). There was no difference in catheterization success between the two groups (p:0.152; p:0.152; p:0.152; p:0.212). However, diabetes mellitus (OR: 2.043, P: 0.027, CI 95%: 1.26-46.9), hypertension (OR: 1.603, P: 0.042, CI 95%: 1.05-23.29) and end-diastolic low flow (OR: 0.221, P: 0.023, CI 95%: 0.662-0.970) was determined as a risk factor for catheterization failure. Conclusion: Considering the radial arterial flows; Peak Systolic and End-Diastolic arterial flows measured during cannulation with local anesthesia were higher than those measured after general anesthesia. MAP decrease with general anesthesia may be one of the main markers of arterial blood flow response. In the study, when the catheterization successes of the local anesthesia and general anesthesia groups were examined, no significant difference was found.Diabetes mellitus, hypertension, and end-diastolic arterial flow were found to be risk factors for first-pass failure.The cut-off value for peak systolic radial artery flow was 33.6 cm/s; The cut-off for end diastolic radial artery flow was 7.6 cm/sec. We think that arterial catheterization failure is higher in flows below these values. Keywords: invasive arterial catheterization, flow, USG