The anatomic relationship between the internal jugular vein and the carotid artery in children after laryngeal mask insertion. An ultrasonographic study

Abstract

This study demonstrates that the IJV is anterior or anterolateral to the artery in the majority of cases and that the anatomic relationship may change following the insertion of the LMA. It supports the need for using ultrasound-guided techniques for IJV cannulation following LMA insertion in spontaneously breathing children.

The airway device preference may affect the overlapping of the common carotid artery by the internal jugular vein

“…Although Nagaraja et al . clearly demonstrated a 8.3% change in the position of IJV after laryngeal mask airway insertion, they did not clarify the number of patients with no position change in IJV and also the number of patients with IJV position changes between different locations such as anterolateral to anterior or just the opposite. Therefore, in the present study, we aimed to study the effect of laryngeal mask airway and ETT insertion and the impact of head rotation on IJV location change (Table ).…”

“…In another report, Nagaraja et al . studied the anatomical relationship between the IJV and the CCA after laryngeal mask airway insertion in a neutral head position in 60 healthy subjects aged 2–16, and showed anatomical changes in only 8.3% of the study subjects after laryngeal mask airway insertion. Similarly, we also found no difference in the neutral head position after laryngeal mask airway insertion compared to before insertion.…”

“…For instance, Nagaraja et al . revealed that anatomical changes were present in only 8.3% of healthy pediatric population after laryngeal mask airway insertion without knowing the direction of these changes. To our knowledge, no reported study has compared sonoanatomic changes in the related vessels before and after the insertion of an ETT in this group.…”

“…Laryngeal mask airway, on the other hand, is commonly the first choice for patients receiving anesthesia to insert a central venous catheter for treatments such as chemotherapy, apheresis, or hemodialysis. There are conflicting results as to whether the placement of laryngeal mask airway changes the anatomical relationship between the IJV and CCA in pediatric populations (1,10). For instance, Nagaraja et al (1) revealed that anatomical changes were present in only 8.3% of healthy pediatric population after laryngeal mask airway insertion without knowing the direction of these changes.…”

“…There are conflicting results as to whether the placement of laryngeal mask airway changes the anatomical relationship between the IJV and CCA in pediatric populations (1,10). For instance, Nagaraja et al (1) revealed that anatomical changes were present in only 8.3% of healthy pediatric population after laryngeal mask airway insertion without knowing the direction of these changes. To our knowledge, no reported study has compared sonoanatomic changes in the related vessels before and after the insertion of an ETT in this group.…”