• T Lamkinsi, A Kettani, Z Belkhadir, J Tadili, M Y Benjelloun, A Mosadik, S Ahid, and M Faroudy.
• Laboratoire de génétique et biométrie, faculté des Sciences, université Ibn Tofail, BP 133, Kénitra, Maroc. tlamkinsi@hotmail.com
• Ann Fr Anesth Reanim. 2012 Jun 1;31(6):512-6.

ObjectivesThe aim of this study was to compare two approaches used for internal jugular venous cannulation: the anterior way, described by English et al. and the posterior way, described by Jernigan et al. The primary endpoint was the rate of success. The secondary endpoints were the related adverse events and the difficulty factors.Study DesignProspective, randomized open clinical trial.Patients And MethodsThe study took place in the vital emergency room, the operating room and the emergency intensive care unit of Ibn Sina University hospital (Rabat, Morocco), between June and September 2010. Hundred and one patients needing a central venous catheter were randomized to undergo one of the two techniques. We compared: demographics, success rates, number of attempts, difficulty factors and adverse events.ResultsThe success rate was significantly higher in the posterior group (96% versus 68%, P < 0.001), with fewer attempts (1.3 ± 0.7 versus 2.1 ± 1.3; P < 0.001). There were less pneumothorax, (0 versus 6%) and more accidental arterial punctures (34 versus 25.5%) in the posterior group, but the difference wasn't significant. Finally, none of the difficulty factors were correlated to the failure rate.ConclusionThis study shows that the posterior approach in internal jugular venous cannulation is more efficient than and as safe as the anterior approach.Copyright © 2012 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

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