Comparative Analysis Of Different Insertion Sites Of Subclavian Vein Cannulation Via Infraclavicular Approach

Objective: To investigate the advantages and disadvantages of subclavian vein cannulation via infraclavicular approach at different insertion sites.Methods: 183 candidates were divided into the medial group(MG,n=93) and lateral group(LG,n=90). The puncture point was fixed at 1.0-1.5 cm below junction of the inner 1/3 and middle 1/3 of the clavicle in MG and the direction of needle is toward the midpoint between sternoclavicular joint and the inferior border of thyroid cartilage. And in LG the puncture point was fixed at 1.5-2.0 cm below the middle line of the clavicle and the direction is toward suprasternal notch. To observe success rate, operative time and complication rate.Results: In MG 85 cases(91.40%)was successfully punctured at first attempt and 6 cases(6.45%)succeeded at second or more attempts,2 case was failed(2.15%). The overall success rate was 97.85%. In LG 71 cases(78.89%)was successfully punctured at first attempt and 11 cases(12.22%)succeeded at second or more attempts,8 cases was failed(8.89%). The overall puncture success rate was 91.11%. The first success rate and the failure rate had significant differences between these two groups (both P<0.05). The operative time of MG was shorter than LG(6.58±3.53 min vs 12.32±3.28min, P< 0.05). The comparison of complication had a significant difference between MG and LG(2 cases vs 5 cases,P<0.05).Conclusion: Compared with LG,MG have higher success rate,less operative time and lower complication rate.MG can serve as first choice of insertion site of subclavian vein cannulation via infraclavicular approach.