Comparison between supraclavicular and infraclavicular approaches for subclavian venous catheterization in adults

Introduction: The subclavian vein access has been the standard recommended approach for central venous catheterization both for short and long-term use. Aim is to compare the supraclavicular and infraclavicular approaches for subclavian venous cannulation in regard to success, attempts required, time taken and complications. Material and Methods: All patients satisfying the inclusion criteria were placed either in group supraclavicular (S) or group infraclavicular (I) approach for right subclavian vein and 7FrG cannula was cannulated using modified Seldinger technique under general anaesthesia. Results: Time taken for successful cannulation in Group (S) were 188.96 +/- 37.19 seconds and in Group (I) were 299.76 +/- 69.712 seconds which was statistically significant with p value of < 0.001. Success of cannulation in Group (S) was 95 %, where as in Group (I) was 92.5%. In Group (S) 85% cannulas were secured in 1st attempt, 10% in 2nd attempt and 5% had failed cannulation. In Group (I) 67.5% were secured in 1st attempt, 25% in 2nd attempt and 7.5% had failed cannulation. Complications in terms of arterial puncture, malposition and pneumothorax were comparable. All these parameters were not statistically significant between the groups with p value > 0.05. Supraclavicular approach is better than infraclavicular approach in terms of less mean time required for successful cannulation. Conclusion: Subclavian venous catheterization via the supraclavicular approach is aquicker method of central venous access in anesthesia.