Is head rotation preferred during right internal jugular vein cannulation in obese asians?

Jae Hee Woo, Youn Jin Kim, Dong Yeon Kim, Hee Jung Baik, Jong Hak Kim, Jong In Han

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Obese subjects are considered to be a difficult group for central vein cannulation. We investigated the optimal position for right internal jugular vein (IJV) cannulation in relation to BMI in Asians. Methods: 102 subjects were divided into three groups; 34 with a BMI of less than 25 kg/m2 (Group III), 34 with a BMI from 25 to 30 kg/m2 (Group II), and 34 with a BMI of 30 kg/m2 or above (Group III). Using a 5-12 MHz linear probe of an ultrasound system, the IJV depth, the diameter of the IJV and common carotid artery (CCA) and overlap length between them were measured at six positions: 0°, 30°, and 60° of head rotation to the contralateral side combined with 0° and 10° of Trendelenburg tilt. Results: The IJV depth was deepest in Group III and significantly shorter at 10° Trendelenburg tilt compared to 0° Trendelenburg tilt. The IJV diameter increased by 10 to 20% with 10° Trendelenburg tilt and there were not significant change by head rotation or BMI. The overlap of the IJV and CCA was significantly increased in Group III compared to Group I and in Group III, there were significant increases of the overlap according to the degree of head rotation, regardless of Trendelenburg tilt. Conclusion: We recommend head rotation less than 30° with 10° Trendelenburg tilt for right IJV cannulation, especially in obese Asians. In obese subjects, real-time ultrasound should be considered. Further study with actual cannulation is needed for availability of clinical outcome.

Original languageEnglish
JournalJournal of Anesthesia and Clinical Research
Issue number10
StatePublished - Oct 2012


  • Body mass index
  • Cannulation
  • Common carotid artery
  • Internal jugular vein
  • Superior vena cava


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