Abstract
Objective: Distal radial artery (dRA) cannulation for invasive blood pressure monitoring under ultrasound (US) guidance is a technically challenging operation in adult patients. However, the learning curve for this technique has not yet been clarified. The aim of this study was to assess the learning curve of US-guided dRA cannulation among novice anesthesiologists.
Methods: We prospective included the first 180 cases who underwent US-guided dRA cannulationperformed by three third-year residents in anesthesiology from December 2022 to June 2023. Cumulative sum analysis (CUSUM) curves were created to identify the turning point (TP).
Results:The mean number of patients needed to overcome the learning curve for overall procedural time, identification time and cannulation time were all 20 cases. Subgroup analysis showed that the TP of overall procedural time was 21, 17, and 22 for operators respectively. The TP of identification time that was 21, 17, and 23 for operators respectively. The TP of cannulation time that was 18, 11, and 22 respectively. The overall procedural time, identification time and cannulation time in the post-TP group were less than in the pre-TP group. The first-attempt success rate and number of needle attempts were higher in the post-TP group. However, there was no statistically difference in the incidences of puncture-related complications.
Conclusions: The learning curve of US-guided dRA cannulation seems to stabilize after approximately successful 20 cases for inexperienced novices. Increased practice may help novice anesthesiologists to achieve proficiency faster.