• Jeong Min Sung, Young Eun Jun, Yun Do Jung, and Kyu Nam Kim.
• Department of Anesthesiology and Pain Medicine, Hanyang University Hospital, College of Medicine, Seoul, Republic of Korea.
• J. Cardiothorac. Vasc. Anesth. 2023 Dec 1; 37 (12): 247524812475-2481.

ObjectivesThe authors compared the dynamic needle tip positioning (DNTP) technique and the long-axis in-plane (LAIP) technique in older patients.DesignThis was a prospective randomized controlled study.SettingThe study was conducted at a single institution (Hanyang University hospital).ParticipantsOne hundred sixty patients participated in this study.InterventionsThis study was conducted on patients aged 75 years or older who underwent general anesthesia requiring placement of an arterial catheter. A total of 160 patients were allocated randomly to the DNTP group or the LAIP group. The primary outcome was the success rate of the first attempt. Additionally, overall success rate, cannulation time, number of total redirections and attempts, and occurrence of complications were investigated.Measurements And Main ResultsIn the DNTP group, the success rate of the first attempt (85% v 48.8%, p < 0.001, relative risk = 1.74, 95% CI 1.37-2.22) and the overall success rate (97.5% v 86.3%, p = 0.01, relative risk = 1.13, 95% CI 1.03-1.24) were significantly higher than in the LAIP group. Fewer redirections (p < 0.001) and attempts (p < 0.001), and a decreased cannulation time (58.8 ± 22.4 s v 89.6 ± 37.9 s, p < 0.001) were detected in the DNTP group. A decreased occurrence of hematoma in the DNTP group also was detected (7.5% v 18.8%, p = 0.035, relative risk = 0.40, 95% CI = 0.16-0.98).ConclusionsThe DNTP technique has better efficiency and safety than the LAIP technique for radial artery catheterization in the older population.Copyright © 2023 Elsevier Inc. All rights reserved.

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