• Quanhong Zhou, Jun Yao, Yongzhu Chen, Jie Lu, Xiaoli Zhang, and Wei Jiang.
• Department of Anesthesiology, Shanghai Jiaotong University Affiliated, Shanghai Sixth People's Hospital, Shanghai - China.
• J Vasc Access. 2015 Mar 1; 16 (2): 158-62.

PurposeRelatively small radial artery may be challenging for cannulation. We investigated whether a distal tourniquet would inflate the proximal radial artery and therefore facilitate cannulation in adults.MethodsThere were two stages of the study. The first was to measure the characteristics of radial artery by ultrasound imaging before and after tourniquet in volunteers. The second was a prospective, randomized, double blind study. Forty patients (American Society of Anesthesiologists I-III) who needed artery cannulation during operation were enrolled. Patients were assigned into two groups: loosen or tightened tourniquet for proximal radial artery cannulation by traditional palpation technique. The primary endpoints were the success rates and time of first attempt success by traditional palpation technique. The time of success after two to three attempts, failure rates and complications were collected.ResultsFor volunteers, the distal tourniquet significantly expanded the cross-sectional up-forward diameter (p<0.001) and the area (p<0.05), but had no effect on cross-sectional lateral-lateral diameter or circumference of proximal radial artery (p>0.05). The success rate of first attempt was higher in the tighten group (75%) than in the loosen group (15%, p<0.05), but the time for success of first attempt/two to three attempts was similar (19.33 ± 1.12/62.11 ± 37.03 sec loosen group vs. 19.07 ± 12.75/45.55 ± 8.98 sec tightened group, p>0.05). Both groups had same failure rates of 10%. No complication was observed.ConclusionsDistal tourniquet could inflate the proximal radial artery and facilitate palpation of radial artery cannulation.

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