Internal jugular vein cannulation: time required under ultrasonographic guidance with a valsalva maneuver.

Time required for the cannulation of right internal jugular vein (IJV) under ultrasonographic guidance with a Valsalva maneuver was investigated in surgical patients. The degree of distension of the IJV and the changes in blood pressure (BP) during the maneuver were also examined. The required time for the cannulation was 11 +/- 5 sec (mean +/- SD, n = 21), and there was no failure in the cannulation. The mean BP decreased significantly during the maneuver, while the vessels enlarged approximately twofold, which facilitated the cannulation. The decrease in BP and the enlargement of the vessels during a Valsalva maneuver were confirmed in the left side, which indicated the feasibility of left IJV cannulation under ultrasonographic guidance.