‘Lignocaine stylet’: Tips for difficult arterial cannulation with minimum arterial spasm

Abstract

Citation: Samanta S, Samanta S, Soni KD and Aggarwal R. ‘Lignocaine stylet’: Tips fordifficult arterial cannulation with minimum arterial spasm. Anaesth Pain & Inensive Care 2014;18(3):314-15

Commonly used methods for arterial cannulation are over the guide wire or over the needle technique.¹ First attempt is the best attempt in arterial cannulation. In many conditions, it is not possible to cannulate artery in first attempt. Puncture site hematoma, spasm of artery result in disappearance of pulse and it creates difficulty in immediate further attempts. We describe a simple technique to overcome the difficulty related to repeated attempts in arterial cannulation.

We attempted radial artery cannulation in left hand with 20G cannula (BD Venflon^TM Pro IV Cannula, Becton Dickinson, Helsingborg, Sweden) in a patient with pancreatitis. First attempt was unsuccessful in negotiating the cannula into the artery. With repeated attempts radial artery went into spasm and pulse disappeared. Before trying to another artery we applied a simple modification to the technique in the same artery. We punctured the artery with a new cannula after distal white stopper removal (Figure 1) at the previous puncture point.