La voie veineuse sous-claviere en anesthesie

Cannulation of the subclavian vein, as first described by French authors, is easily performed in the following steps: 1. A wheal is raised below the clavicle, at the junction of the inner and middle thirds of the bone. 2. A 3-inch no. 18 needle, attached to a syringe, is inserted through the wheal in a medial, cranial and dorsal direction. Proportionately smaller needles are used in children. 3. With suction applied to the syringe, the needle is slowly advanced, hugging the under surface of the clavicle, until the costoclavicular ligament is piercec This ligament yields with the feel of the dura mater. 4. A few millimetres beyond this point the vein is entered and the syringe suddenly fills with blood. 5. Aspiration in the four quadrants assures that the entire bevel is within the lumen The syringe is exchanged for the tubing of the intravenous drip and the latter is secured by a piece of tape to prevent drag on the needle. Aspiration is repeated following each change of position and prior to the injection of any drug to verify the correct position of the needle.