Radial Artery Cannulation

This randomized controlled study aims to compare short-axis/out-of-plane and long-axis/in-plane ultrasound-guided techniques for radial artery cannulation in adult patients undergoing elective surgery. The study will also investigate whether the depth of the radial artery from the skin is associated with cannulation success and may help guide the selection of the ultrasound-guided cannulation technique. Participants will be randomly assigned to either the short-axis/out-of-plane group or the long-axis/in-plane group. Radial artery depth will be measured using ultrasound before cannulation. The two techniques will be compared in terms of cannulation success, including first-attempt success, number of punctures and needle redirections, time to successful cannulation, failed cannulation, and procedure-related complications.

Radial artery cannulation is a routine procedure for invasive hemodynamic monitoring for patients undergoing cardiovascular surgery patients. Although ultrasound (USG) guidance is known to improve success rates, there is limited data comparing the efficacy of the 'Direct' versus 'Seldinger' techniques specifically in patients with anticipated difficult radial access. This study aims to compare the effectiveness of USG-guided Direct cannulation and USG-guided Seldinger techniques in adult patients with anticipated difficult radial arterial cannulation.