Comparison of a Novel Geometric Landmark Method Versus Conventional Palpation Technique for Central Venous Cannulation: A Comparative Observational Study of Two Techniques.

Abstract

Objective: To compare the effectiveness and safety of a novel geometric landmark technique with the conventional palpation technique for central venous cannulation.

Study design: Comparative observational study.

Place and duration of the study: This study was conducted at National Medical Centre (NMC) from January 01, 2025 to June 30, 2025.

Methods: A total of 100 adult patients requiring central venous cannulation were enrolled and allocated into two groups based on the technique used. Group A (n = 50) underwent cannulation using the geometric landmark method, while Group B (n = 50) underwent cannulation using the conventional palpation technique. First-attempt success rate was the main outcome. Secondary outcomes were the number of attempts, arterial puncture, and change of technique. SPSS software was used for analysis. Chi-square test was used to compare categorical variables whereas the Mann-Whitney U test was applied to the non-normally distributed continuous variables. A P value of less than 0.05 was considered statistically significant.

Results: First-attempt success was significantly higher in the geometric landmark group compared to the palpation group (98% vs. 86%; P = 0.027). The geometric landmark technique was associated with fewer cannulation attempts (mean 1.00 ± 0.00 vs. 1.18 ± 0.57; P = 0.012). Arterial puncture occurred in one patient (2%) in each group, with no statistically significant difference (P = 1.000). Technique change was required in one patient (2%) in each group, with no statistically significant difference between the two techniques (P = 1.000). The two groups had similar baseline demographic and clinical characteristics.

Conclusion: The geometric landmark technique significantly improves first-attempt success and reduces the number of cannulation attempts compared with the conventional palpation method while maintaining a comparable safety profile. This technique represents a practical and cost-effective alternative for central venous cannulation, particularly in resource-limited settings.