• Sung-Won Min, Hyong-Rae Cho, Young-Tae Jeon, Ah-Young Oh, Hee-Pyoung Park, Chun Woo Yang, Woo Hee Choi, and Byung-Gun Kim.
• Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Seoul, South Korea.
• BMC Anesthesiol. 2016 Jul 11; 16 (1): 34.

BackgroundThis study assessed the effect of bevel direction on the success rate of ultrasound guided radial artery catheterization.MethodsA total of 204 patients requiring radial artery catheterization were randomly divided into bevel-up (n = 102) and bevel-down (n = 102) groups. Success rate, cannulation time, and number of attempts were compared groups.ResultsIn the bevel-down group, an arterial line was placed on the first attempt in 86 of 102 (84.3 %; 95 % confidence interval [CI] = 76 % to 90 %) patients versus 73 of 102 (71.6 %; 95 % CI = 62.1 % to 79.4 %) in the bevel-up group (p = 0.028). In the bevel-down group, the mean time to a successful radial arterial cannulation was 33.3 ± 6.3 seconds (95 % CI = 32.1-34.6) versus 35.9 ± 7.6 seconds (95 % CI = 34.4-37.2) in the bevel-up group (p = 0.011). The median score was 33.2 and interquartile range [IQR] was 10.9 (30.3-41.2) for the mean cannulation time in the bevel-up group. In the bevel-down group, the mean score was 32.3 (IQR 3.90, 30-33.9) for mean cannulation time. In the bevel-down group, 11 of 102 (7 %; 95 % CI = 0 to 16 %) patients developed a posterior wall puncture versus 22 of 102 ((21.6 %; 95 % CI = 14.7 to 17.2 %) in the bevel-up group.ConclusionThe bevel-down approach during ultrasound-guided radial artery catheterization exhibited a higher success with fewer complications compared to the bevel-up approach.Trial RegistrationClinical Research Information Service is Korean Clinical Trials Registry ( KCT0001836 ). It was registered retrospectively 30th Nov 2015.

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