Effect of head rotation on overlap and relative position of internal jugular vein to carotid artery in infants and children: A study of the anatomy using ultrasonography☆☆☆
published online 11 February 2010.
Abstract
Purpose
The aim of this study was to evaluate the influence of head rotation on the relative anatomy of internal jugular vein (IJV) and carotid artery (CA) in infants and children.
Materials and Methods
Two hundred pediatric patients (26.5 ± 23.3 months old) who were undergoing elective surgery were eligible for this consecutive and prospective study. Using 2-dimensional ultrasound, the amount of overlap and the relative position of the 2 vessels were compared between heads in the neutral position and in 90° of rotation.
Results
The mean percentage overlap of CA by IJV in the neutral position increased significantly as the head was rotated to the right (23.3% vs 39.2%) and left (35.3% vs 52.8%). The incidence of lateral positioning of IJV to CA decreased significantly when the head was rotated (40% vs 21% in right, 26.5% vs 10.5% in left). The right IJV is associated with less overlap of the CA than the left, regardless of head position.
Conclusions
The head should be kept in as near a neutral position as possible because the overlap increased by head rotation in both sides. In addition, the right IJV should be preferred because of less CA overlap and more lateral positioning than the left.
Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, 120-752, South Korea
Corresponding author. Department of Anesthesiology and Pain Medicine, Severance Hospital, 120-752 Seoul, South Korea. Tel.: +82 2 2228 2422; fax: +82 2 312 7185.
☆ No funding or other financial support was received.
☆☆ No conflict of interest to declare in the study.
ABSTRACT