Internal jugular vein (IJV) catheterization is a common invasive procedure performed under ultrasound (USG) guidance. Providing effective analgesia during the procedure is essential for patient comfort. This prospective, randomized controlled study aims to compare the clinical efficacy, onset time, required local anesthetic volume, and hemodynamic stability between ultrasound-guided local infiltration anesthesia (LIA) and ultrasound-guided superficial cervical plexus block (SCPB) using different volumes (2 mL, 5 mL, and 10 mL of 1% lidocaine) in patients undergoing IJV catheterization.
Central venous catheterization (CVC) is a widely used invasive procedure in critically ill and high-risk surgical patients for fluid resuscitation, hemodynamic monitoring, continuous infusion of vasoactive or venosclerotic drugs, and hemodialysis/hemofiltration. Among available vascular access sites, internal jugular vein (IJV) cannulation is the most commonly preferred route. However, awake patients undergoing IJV catheterization often experience significant pain and distress, which may negatively impact hemodynamic stability, patient comfort, and procedural success. Although local infiltration anesthesia (LIA) is traditionally used to provide analgesia during IJV catheterization, it frequently falls short of providing optimal pain control. Ultrasound-guided regional anesthesia techniques, such as superficial cervical plexus block (SCPB), have emerged as effective alternatives for procedures involving the anterolateral neck region. While both LIA and SCPB are utilized in clinical practice, there is a lack of prospective randomized literature directly comparing different local anesthetic volumes, onset times, and overall clinical efficacy between these two approaches. This prospective, randomized controlled trial aims to evaluate and compare ultrasound-guided LIA and SCPB in terms of anesthetic efficacy, onset time, required local anesthetic volume, and hemodynamic stability in patients undergoing IJV catheterization.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
150
Administration of 1% lidocaine hydrochloride either via ultrasound-guided superficial cervical plexus block (at 2 mL, 5 mL, or 10 mL volumes) or via subcutaneous local infiltration (10 mL) prior to internal jugular vein catheterization.
kayseri City Hospital Department of Anesthesiology and Reanimation
Kayseri, Turkey (Türkiye)
Time to Effective Block Onset Across Different Local Anesthetic Volumes
Time elapsed (in seconds) from injection completion until effective analgesia is achieved (defined as an NRS score ≤ 2 via pin-prick test every 5 seconds), evaluating whether lower volumes of SCPB (2 mL and 5 mL) achieve effective block onset in a comparable timeframe to higher volume SCPB (10 mL) and standard LIA (10 mL).
Time frame: Evaluated every 5 seconds, up to 5 minutes post-injection.
Time to Effective Block Onset Across Different Local Anesthetic Volumes
Time elapsed (in seconds) from injection completion until effective analgesia is achieved (defined as an NRS score ≤ 2 via pin-prick test every 5 seconds), evaluating whether lower volumes of SCPB (2 mL and 5 mL) achieve effective block onset in a comparable timeframe to higher volume SCPB (10 mL) and standard LIA (10 mL).
Time frame: Evaluated every 5 seconds, up to 5 minutes post-injection
Pain Intensity Across Procedural Stages (NRS Scores)
Evaluation of pain intensity using the Numerical Rating Scale (NRS, 0 = no pain to 10 = worst pain) to compare whether low-volume SCPB provides comparable pain control to high-volume SCPB and LIA across different procedural steps.
Time frame: At baseline, during infiltration/block injection, during initial needle insertion, and during catheter placement.
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