Comparison of short-axis and oblique-axis approaches for ultrasound-guided right internal jugular vein cannulation in the left decubitus position: a randomized clinical trial study protocol

Background The internal jugular vein (IJV) cannulation in the decubitus position is required in some urgent and special clinical situations, increasing the difficulty of performance. Although ultrasound guidance can improve the efficiency and safety of IJV cannulation, ultrasound guidance for right internal jugular vein (RIJV) cannulation in the decubitus position has not been studied. This trial aims to compare the feasibility and safety of an ultrasound-guided oblique-axis approach with a short-axis approach for left decubitus RIJV cannulation. Methods A total of 74 patients undergoing IJV cannulation in the left decubitus position under general anesthesia will be randomly divided into two groups: the oblique-axis group (OA group) and the short-axis group (SA group). In both groups, the surgical bed will be rotated 20° to the Trendelenburg position prior to puncture to allow for better filling of the RIJV for catheterization. The primary endpoint is the first-time puncture rate. Secondary endpoints include overall catheterization success rate, overall catheterization time, number of venipuncture attempts, and incidence of mechanical complications. Discussion We hypothesize that the feasibility and safety of the ultrasound-guided oblique-axis approach for RIJV cannulation will be superior to those of the short-axis approach in the left decubitus position. Our findings may provide a clinical preference for central venous cannulation in certain position for surgical patients. Clinical Trial Registration: Chinese Clinical Trial Registry (chictr.org.cn)， identifier ChiCTR2400091385. Registered on October 28, 2024. https://www.chictr.org.cn/bin/project/edit?pid=247627