Effectiveness of AccuVein AV400 Device versus ultrasound-guided Cannulation of the Great Saphenous vein at the Ankle in Infants: A Randomized Controlled Trial

Background: In pediatric patients, peripheral venous access can be very difficult and repeated attempts may be needed. Several devices have been developed to facilitate venous cannulation. Some of them used the near-infrared rays reflecting system for venous visualization. Other used ultrasound to perform venous cannulation. The primary goal was to investigate the practicability of ultrasound-guided vascular access versus AccuVein AV 400 for cannulation of great saphenous vein at the level of the medial malleoli in infants ≤12 months. Methods: Prospective, double blinded and randomized study on eighty patients in each group. ASA I and II Infants' ≤12 months were enrolled in the study. Infants were randomly assigned into two groups; an AV400 group and an ultrasound guided group .The observer recorded the time of tourniquet application, the time of successful cannulation and the number of cannulation attempts. The puncture site was evaluated to detect possible hematoma or local infection. Results: There was significant statistical difference in cannulation time and tourniquet time between the two groups. In ultrasound group, mean time for tourniquet was 54.05 ± 26.7 seconds and for AV400, it was 33.95 ± 19.1 seconds. As regard the cannulation time, the mean time in the ultrasound group was 41.4 ± 24.9 seconds and it was 25.1 ± 17.8 seconds in the AV400 group. Conclusion: AccuVein 400 and ultrasound-guided vascular access in infants ≤12 months are a promising techniques to be used in pediatric anesthesia. But with the AccuVein 400 the time of tourniquet and cannulation was shorter than with the use of the ultrasound.