Safety And Efficacy Of Using Central Venous Catheters Through The Femoral Artery For Invasive Blood Pressure Monitoring In Scoliosis Surgery

Objective To explore the safety and efficacy of using central venous catheters through the femoral artery for invasive blood pressure monitoring in scoliosis surgery.Methods A total of 24 patients were selected from August,2015 to October,2016 who undergone scoliosis surgery,with a physical status according to American Society of Anesthesiologists(ASA)???.The patients were randomly divided into A(experiment group)and group B(control group).The induction of anesthesia were accomplished with intravenous in both groups,and all patients were operated under general anesthesia with endotracheal intubation.After anesthesia induction,patients in group A got one of their their radial arteries cannulated with 22 angiocatheters,and then got their femoral arteries on the same side cannulated with central venous catheters.Both of the catheters were connected to a transducer and for invasive blood pressure monitoring.Patients in group B only had their radial arteries cannulated.We recorded the change of patients' systolic arterial pressure(SAP),diastolic arterial pressure(DAP),mean arterial pressure(MAP)and heart rate(HR)at 8 time points:before operation(Ti),the beginning of orthopedics(T2),when undergoing fast blood loss(T 3),intraoperative wake-up test(T4),postoperative wake-up test(T5),arriving ICU(T6),6 hours after entering ICU(T7),12 hours after entering ICU(Ts).In addition,we observed and recorded if there were difficult cannulation,whether radial artery or femoral artery catheters were flexed or prolapsed,or other complications such as thrombosis formation,small hematomas and errhysis,catheter-related injections,and ischemia of lower limbs undergoing femoral cannulation.1 week after the operations,we made follow-up appointments with patients in group A to find out if catheter-related infection had happened.We compared the SAP,DAP and MAP of patients' radial arteries and femoral arteries in group A,and the SAP,DAP and MAP of patients' femoral arteries in group A and of of patients' radial arteries in group B.Further more,patients' heart rate was compared between two groups.In addition,we also compared the incidence of difficult cannulation,catheters prolapsed or felxed,thrombosis formation,small hematomas and errhysis,catheter-related injections,and ischemia of the lower limbs undergoing femoral cannulation.Results There was no significant difference between two groups on age,height,weight and duration of surgery(P>0.05);In group A,the SAP,DAP and MAP of radial arteries and femoral arteries showed no significant difference(P>0.05);There was no significant difference of the SAP,DAP and MAP between the femoral arteries in group A and the radial arteries in group B(P>0.05);the heart rate of the two groups had no significant difference(P>0.05),either.All of the 24 patients were undergoing radial artery cannulations,4 cases of them experienced difficult cannulation(16.7%)(2 cases of group A and 2 cases of group B),5 cases had catheters flexed(20.8%),including 3 cases of group A and 2 cases of group B;and 2 cases of them had catheters prolapse(8.3%)(each of group A and B had 1 case).The incidence of vasospasm was 4.2%.Small hematomas were observed in 3 cases and the incidence was 12.5%.2 people experienced errhysis after the catheters were removed.None of 12 cases in group A had hemodynamic disorder or abnormal catheter prolapse or flexed.1 of them experienced small hematoms and the incidence of errhysis was 8.3%.No ischemia of lower limbs was observed in group A.We didn't find thrombosis in any patients undergoing radial or femoral cannulation.Conclusion 1 The blood pressure of central venous catheters through the femoral artery is same as radial blood pressure in people undergoing scoliosis surgery.2 The use of central venous catheters through the femoral artery for invasive blood pressure monitoring in people undergoing scoliosis surgery shows lower rate of catheters flexion or prolapse and higher rate of safety.