COMPARATIVE EVALUATION OF REAL-TIME ULTRASONOGRAPHY GUIDED VERSUS CONVENTIONAL ANATOMICAL LANDMARK GUIDED TECHNIQUE FOR CENTRAL VENOUS CANNULATION IN ELECTIVE CARDIAC SURGERY PATIENTS

Central venous catheterization is a critical procedure in cardiac and intensive care practice, with both conventional anatomical landmark technique and real-time ultrasonography guidance being used for internal jugular venous cannulation. This prospective randomized study compared the efficacy, safety, and procedural characteristics of ultrasound-guided cannulation with the landmark technique in 76 adult patients undergoing elective cardiac surgery. All procedures were performed by an experienced anesthesiologist, and outcomes included number of attempts, access time, total cannulation time, overall success rate, and procedure-related complications. The ultrasound group demonstrated significantly shorter access time (39 vs 118 seconds, p = 0.001) and total cannulation time (225.84 vs 438.95 seconds, p < 0.001). Although overall success rates were comparable (76.32% vs 78.95%, p = 1.00), complications such as carotid artery puncture and hematoma occurred only in the landmark group. No cases of pneumothorax, hemothorax, or catheter malposition were observed in either group. The findings indicate that ultrasound guidance facilitates faster venous access with fewer complications, supporting its routine use in central venous cannulation, particularly in cardiac surgical patients.