Abstract:

Objectivve　To investigate the effects of different degrees of positive end expiratory pressure (PEEP) on the cross-sectional areas (CSAs) and puncture and catheterization of right internal jugular vein (RIJV) in anesthetized patients.　Methods 　A total of 304 patients with selective cardiac operation were divided into four groups by random number table method: group A (PEEP=0 cmH2O), group B (PEEP=5 cmH2O), group C (PEEP=10 cmH2O), group D(PEEP=15 cm H2O). The CSAs of RIJV were measured by ultrasonography. Total puncture times, inadvertent carotid puncture times, easiness of withdrawing blood, cases of hematoma formation, cases of RIJV puncture failure were recorded. Bradycadia and hypotension were recorded．Results　CSAs of RIJV after PEEP in group C and group D were both significantly increased compared to that before PEEP (P<0.05); The CSAs of RIJV in group C and group D after PEEP were significantly larger than that of both group A and group B (P<0.05). The success rates of RIJV puncture at first attempt in group C and group D were significantly higher than that of both group A and group B (P<0.05). The incidence of inadvertent carotid puncture, local hematoma formation and puncture failure in group C and group D after PEEP were significantly lower than that of both group A and group B (P<0.05). The incidence of bradycardia and hypotension in group D were significantly higher than that of the other three groups (P<0.05).　Conclusions　Appropriate PEEP significantly increases the CSA of RIJV, increases the success rate of puncture, and decreases the incidence ofcomplications.

Key words: Positive end expiratory pressure, Puncture, Catheterization, Internal jugular vein, General anesthesia