Newly Published
Perioperative Medicine  |   July 2017
Posterior Tibial Artery as an Alternative to the Radial Artery for Arterial Cannulation Site in Small Children: A Randomized Controlled Study
Author Notes
  • From the Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
  • Submitted for publication April 18, 2016. Accepted for publication May 18, 2017.
    Submitted for publication April 18, 2016. Accepted for publication May 18, 2017.×
  • Research Support: Support was provided from solely institutional and/or department sources.
    Research Support: Support was provided from solely institutional and/or department sources.×
  • Competing Interests: The authors declare no competing interests.
    Competing Interests: The authors declare no competing interests.×
  • Reproducible Science: Full protocol available at: dami0605@snu.ac.kr. Raw data available at: dami0605@snu.ac.kr.
    Reproducible Science: Full protocol available at: dami0605@snu.ac.kr. Raw data available at: dami0605@snu.ac.kr.×
  • Correspondence: Address correspondence to Dr. Kim: Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea. dami0605@snu.ac.kr. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Perioperative Medicine / Pediatric Anesthesia
Perioperative Medicine   |   July 2017
Posterior Tibial Artery as an Alternative to the Radial Artery for Arterial Cannulation Site in Small Children: A Randomized Controlled Study
Anesthesiology Newly Published on July 10, 2017. doi:10.1097/ALN.0000000000001774
Anesthesiology Newly Published on July 10, 2017. doi:10.1097/ALN.0000000000001774
Abstract

Background: We evaluated the posterior tibial artery as an alternative arterial cannulation site to the radial artery in small children.

Methods: A two-stage study was conducted. First, we evaluated the anatomical characteristics of the posterior tibial artery compared with the radial and dorsalis pedis arteries. Next, a parallel-arm single-blind randomized controlled study compared the initial success rate of ultrasound-guided arterial cannulation among three arteries as a primary outcome.

Results: Sixty patients were analyzed in the observational study. The diameter of the posterior tibial artery (1.5 ± 0.2 mm) was similar to that of the radial artery (1.5 ± 0.2 mm) and larger than that of the dorsalis pedis artery (1.2 ± 0.2 mm; P < 0.001). The posterior tibial artery has a larger cross-sectional area (2.8 ± 1.1 mm2) compared with the radial (2.3 ± 0.8 mm2; P = 0.013) and dorsalis pedis arteries (1.9 ± 0.6 mm2; P = 0.001). In total, 234 patients were analyzed in the randomized study. The first-attempt success rate of the posterior tibial artery (75%) was similar to that of the radial (83%; P = 0.129; odds ratio, 1.53; 95% CI, 0.69 to 3.37) and higher than that of the dorsalis pedis artery (45%; P < 0.001; odds ratio, 3.95; 95% CI, 1.99 to 7.87). Median cannulation time of the posterior tibial artery (21 s; interquartile range, 14 to 30) was similar to that of the radial artery (27 s; interquartile range, 17 to 37) and shorter than that of the dorsalis pedis artery (34 s; interquartile range, 21 to 50).

Conclusions: The posterior tibial artery is a reasonable alternative to the radial artery for ultrasound-guided arterial cannulation in small children.