Assessment of the clinical efficacy and safety of ultrasound‐guided right internal jugular venocentesis catheterization across various surgical positions: A single‐center, prospective controlled study

Abstract Background Surgical procedures often require specific patient positioning that can complicate internal jugular vein (IJV) catheterization. Objective To investigate the feasibility and complexity of ultrasound‐guided right IJV cannulation in various surgical positions. Methods Patients requiring intra‐operative IJV catheterization were assigned to three groups based on their surgical position: supine, lateral, and prone (Groups 1, 2, & 3, respectively). The primary outcome was the positional relationship between the IJV and the carotid artery. Other measurement indicators were diameters of the long and short axes and cross‐sectional area (CSA) of the IJV, puncture data, incidence of catheterization‐related complications, and operator confidence score. Results Data from 90 patients were analyzed, with successful IJV catheterization achieved in all cases. Anatomically, in the lateral position, the IJV was anterior to the carotid artery in 15 of 30 patients, significantly more than in the supine (6 of 30) and prone groups (5 of 30). The diameters of the long and short axes of the IJV in the non‐supine position significantly differed from those in the supine position while the CSA did not change significantly. However, multivariate Cox regression analysis indicated that these three covariates did not significantly affect the puncture time. Puncture data revealed higher first‐pass success rates, shorter puncture times, and greater operator confidence in the supine than in other groups. No significant differences in complication rates were observed. Conclusions Although the lateral position leads to a more unfavorable relative position of blood vessels, under ultrasound guidance, the anatomical relationship is not the only factor determining the difficulty of the operation. The prone position, due to its extreme physical space limitations and inconvenient operating posture, poses a greater overall challenge, resulting in the lowest puncture efficiency. Performing the initial IJV catheterization in the supine position is recommended to reduce operational difficulties.