Influence Of Venous Pressure Change On Internal Jugular Vein Puncture Catheterization Guided By Ultrasound

Objective: To study the effect of Trendelenburg position,Valsalva movement and positive pressure ventilation on the changes of venous pressure induced by three major factors,and thus on the catheterization of internal jugular vein puncture guided by ultrasound.Methods: We will select the patients who received internal jugular vein puncture catheterization in the Department of Surgical Anesthesiology,the Third Affiliated Hospital of Xinjiang Medical University from December 2021 to December2022.We will select patients between 18 and 75 years old with normal cervical vertebra activity and normal respiratory system,circulatory system and coagulation system as research objects.Patients are required to participate in the study voluntarily and sign informed consent.Patients were divided into experimental group(postural changes,respiratory changes and positive end-expiratory pressure ventilation group)and control group(patients with internal jugular venipentesis in supine state without any intervention)by random number table method.Trendelenburg position was adopted in the observation group.In the respiratory change subgroup,the observation group adopted Valsalva action;After general anesthesia,15 cm H2O PEEP positive pressure ventilation was used in the observation group.Before the operation,understand the basic situation of the patient.After the patient entered the operating room,peripheral venous access was opened and no drugs were given before surgery.We carried out routine oxygen inhalation and vital signs monitoring.Ultrasound-guided assisted puncture was used in each group during the operation,and the Angle between puncture needle and skin was 45°.CVP value and cross-sectional area of internal jugular vein under B-ultrasound were measured in all three groups,as well as whether the internal jugular vein penetrated.Results: The cross-sectional area of the internal jugular vein under the guidance of baseline CVP and B-ultrasound was statistically significant with vascular penetration(P < 0.05),and the cross-sectional area of the internal jugular vein under the guidance of CVP and B-ultrasound was also statistically correlated with vascular penetration after the intervention(P < 0.05).Conclusions: Valsalva can increase the central venous pressure and increase the cross-sectional area of the internal jugular vein in patients undergoing surgery,thus reducing the occurrence of internal jugular vein vascular penetration.