ArCanUS
Research type
Research Study
Full title
Arterial cannulation with ultrasound
IRAS ID
301584
Contact name
Gareth Ackland
Contact email
Sponsor organisation
Joint Research Management Office (JRMO)
Clinicaltrials.gov Identifier
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
A drop in blood pressure during anaesthesia for a surgical procedure has been associated with worse patient outcomes, including complications such as damage to the heart, brain and kidneys. Continuous blood pressure monitoring prior to the start of anaesthesia alerts the anaesthetist to drops in blood pressure and allows this to be treated promptly. This may help to avoid the complications described above.
Continuous blood pressure monitoring is carried out by inserting a small plastic tube (cannula) into an artery. In this study, we propose inserting a cannula into the radial artery in the wrist before a patient is anaesthetised. The usual technique for insertion of this cannula is for the anaesthetist to identify the site of the radial artery by feeling for an arterial pulse with his/her fingers (palpation). An alternative technique for identification is to use ultrasound. Ultrasound creates a two-dimensional image of the area under the skin on a screen, enabling the operator to visualise the artery being targeted. This may reduce the number of cannulation attempts required, reducing patient discomfort.
We will test whether ultrasound guidance improves the success rate of radial artery cannulation, compared to palpation alone, in a randomised controlled trial in an NHS hospital. Patients will be over 45 years old, undergoing anaesthesia for more than 120 minutes. They will be randomly assigned to a palpation or ultrasound-guided technique for arterial cannulation. They will receive numbing local anaesthetic cream to the area beforehand. A needle is used to introduce the cannula into the artery. There will be a maximum of one attempt allowed. In addition to measuring success rate, we will also compare whether the successfully sited cannula requires resiting at any point during the surgery, and any complications which arise. Patients will receive standard anaesthetic and surgical care in all other respects.
REC name
Wales REC 6
REC reference
21/WA/0403
Date of REC Opinion
17 Dec 2021
REC opinion
Favourable Opinion