Comparision of Posterior and Anterior Approaches for Internal Jugular Venous Cannulation – A Prospective & Randomised Controlled Study

Introduction: Of the numerous approaches for internal jugular venous cannulation, anterior approach is being widely practiced. But the major complications of this approach are carotid artery puncture and hematoma. With posterior approach, there is lesser incidence of arterial puncture and hematoma. Materials and Methods: This study was conducted over a period of 9 months. The aim of this study is to compare posterior and anterior approaches for internal jugular vein cannulation in terms of number of attempts, duration of cannulation, ease of insertion and complications of approach by each route. 50 patients were considered for the study and they were randomly allocated into two groups to be cannulated with either anterior approach (Group A; n = 25) or posterior approach (Group B; n = 25). Demographic data was comparable in both groups. Results: The number of attempts, duration of cannulation, incidence of arterial puncture, incidence of arterial puncture and hematoma are less with posterior approach. Ease of threading and chance of catheter displacement were comparable among both groups. Conclusion: The posterior approach is better than anterior approach for internal jugular vein cannulation, as it improves the success rate, permits easy threading of catheter, reduces the access time and duration of cannulation. It reduces complications like arterial puncture, hematoma, pneumothorax, catheter displacement and thrombophlebitis.