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A New Technique of Peripheral Venous Access Under Surgical Drapes in Thoracic Anesthesia

2010; Elsevier BV; Volume: 25; Issue: 3 Linguagem: Inglês

10.1053/j.jvca.2010.06.010

1532-8422

Hirotoshi Kitagawa, Yasuhiko Imashuku, Toji Yamazaki,

Hemodynamic Monitoring and Therapy

During surgery under thoracic anesthesia, occasionally there is the need for an alternative intravenous catheter for blood transfusion or sampling. However, detection of the external jugular vein can be difficult. Furthermore, in such cases, we have experienced difficulty in venous access under the surgical drapes. The dark field under the surgical drapes impedes the detection or puncture of peripheral veins. The StatVein (Technomedica, Yokohama, Japan;) also known as AccuVein AV300, AccuVein LLC, Huntington, NY is a portable and lightweight tool for helping to locate superficial veins. Herein, we describe the use of StatVein for peripheral venous access in dark-field conditions. A 61-year-old woman was scheduled for elective lung resection because of lung cancer. In the operating room, an intravenous catheter was placed, and then general anesthesia was induced with propofol, remifentanil and rocuronium. During the operation, another intravenous catheter was needed for blood transfusion because of pulmonary vascular injury. The detection of the external jugular vein was made difficult by the decubitus position and tube holder. Furthermore, the dark field under the surgical drapes impeded peripheral venous access of the upper limb. To obtain venous access in a dark field, the StatVein was brought to the operating room. When the StatVein was held above the upper limb in the dark field, veins appeared noticeably different from the surrounding tissue. A second intravenous catheter was placed and blood transfusion begun. Thus, infrared laser light in the StatVein shows the position of superficial veins with remarkable clarity because hemoglobin in the vein absorbs infrared light (Fig 1). The StatVein facilitates peripheral venous access under the dark-field condition in thoracic anesthesia.