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KMID : 0356920140670050305
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Korean Journal of Anesthesiology
2014 Volume.67 No. 5 p.305 ~ p.309
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Effect of Trendelenburg position on right and left internal jugular vein cross-sectional area
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Lee Jeong-Gil
Park Hee-Bin
Shin Hye-Young
Kim Ju-Deok
Yu Soo-Bong
Kim Doo-Sik
Ryu Sie-Jeong
Kim Gyeong-Han
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Abstract
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Background: Unlike the right internal jugular vein (RIJV), there is a paucity of data regarding the effect of the Trendelenburg position on the left internal jugular vein (LIJV). The purpose of this study is to investigate the cross-sectional area (CSA) of the LIJV and RIJV and their response to the Trendelenburg position using two-dimensional ultrasound in adult subjects.
Methods: This study enrolled fifty-eight patients with American Society of Anesthesiologists physical status class I-II who were undergoing general anesthesia. CSAs of both the RIJV and LIJV were measured with a two-dimensional ultrasound in the supine position and then in a 10° Trendelenburg position.
Results: In the supine position, the transverse diameter, anteroposterior diameter, and CSA of the RIJV were significantly larger than those of the LIJV (P < 0.001). Of 58 patients, the RIJV CSA was larger than the LIJV CSA in 43 patients (74.1%), and the LIJV CSA was larger than the RIJV CSA in 15 patients (25.9%). In the Trendelenburg position, CSAs of the RIJV and LIJV increased 39.4 and 25.5%, respectively, compared with the supine position. However, RIJV changed at a rate that was significantly greater than that of the LIJV (P < 0.05). Of 58 patients, the RIJV CSA was larger than the LIJV CSA in 48 patients (82.8%), and the LIJV CSA was larger than the RIJV CSA in 10 patients (17.2%).
Conclusions: In supine position, the RIJV CSA was larger than the LIJV CSA. The increased CSA in the Trendelenburg position was greater in the RIJV than the LIJV.
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KEYWORD
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Central venous catheter, Cross-sectional area, Internal jugular vein, Trendelenburg position
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