Comparison between ultrasound-guided dynamic needle tip positioning and palpation technique for radial artery cannulation: Systematic review and meta-analysis.

Abstract

<h4>Background and aims</h4>The dynamic needle tip positioning (DNTP) technique has recently been introduced, but the effectiveness of the DNTP and traditional palpation methods for radial artery cannulation remains unknown. Therefore, we conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) to compare the effectiveness and safety of ultrasound-guided DNTP and palpation techniques during radial artery cannulation in patients undergoing elective surgery.<h4>Methods</h4>We conducted a thorough search of electronic databases from inception through 31 January 2025 to identify relevant studies. We searched PubMed, Embase, Cochrane Library, and Web of Science and identify relevant studies. RCTs comparing US-guided DNTP versus the palpation method in all age groups requiring radial artery cannulation were included. The primary outcome was the first attempt success rate. Secondary outcomes included overall success rate, cannulation time, and incidence of complications. Statistical analysis was performed using RevMan software.<h4>Results</h4>A total of six studies with 388 participants were included. Our meta-analysis showed a higher first-pass success rate in the DNTP group compared to the palpation group (Risk Ratio = 1.44; 95% Confidence Interval: 1.19, 1.73). We also observed a higher overall success rate in the DNTP group. Cannulation times were similar between the two groups. Meta-analysis indicated a lower complication rate in the DNTP group compared to the palpation group.<h4>Conclusion</h4>This meta-analysis showed a higher first-pass success rate and overall success rate and fewer complications in the DNTP group compared to the traditional palpation group during radial artery cannulation. Additionally, there was no significant difference in cannulation time between the two groups.