Journal of Anaesthesia & Critical Care Case Reports

Vol 8 | Issue 3 | September-December 2022 | Page: 12-14 | Harbhajan Singh Saini, Rohit Yadav, Amit Singh, Shreya Sharma

DOI: 10.13107/jaccr.2022.v08i03.208

Author: Harbhajan Singh Saini [1], Rohit Yadav [2], Amit Singh [2], Shreya Sharma [2]

[1] Department of Anaesthesia and Critical Care Medicine, Bansal Hospital, Bhopal, Madhya Pradesh, India.
[2] Department of Critical Care Medicine, Bansal Hospital, Bhopal, Madhya Pradesh, India.

Address of Correspondence
Dr. Harbhajan Singh Saini,
Consultant, Department of Anaesthesia and Critical Care Medicine, Bansal Hospital, Bhopal, Madhya Pradesh, India.
Email: drhssmax@gmail.com

Abstract

Introduction: Placing a central venous catheter (CVC) in presence of permanent pacemaker (PPI) is considered a relative contraindication as it carries the risk of pacing lead misplacement, dislodgement of any clots, dissemination of infection and pacing failure. This is an alternate technique for c.v.c insertion in patients with p.p.i in situ.
Case presentation: The case was conducted in Nayati Hospital, Mathura. The placement of CVC was successfully done after taking informed written consent in supine position taking all aseptic precautions in Operation Theatre (OT) where there was a facility of continuous fluoroscopy. Fluoroscopy helps to ensure that the catheter tip is in the best position and avoid the contact with the pacemaker leads. The use of continuous fluoroscopy spearheads anaesthetist and intensivist away from possible complications enumerated.
Conclusion: We conclude that Fluoroscopy in operating room and cardiac catheterization lab can be used to correctly, accurately and safely place the central venous catheter’s (CVC) via internal jugular vein and subclavian vein with implanted permanent pacemaker whenever the need arises and the cannulation of femoral vein can be avoided to stay away from the complications such as infection and deep vein thrombosis.
Keywords: Pacemaker, Central venous catheter, Fluoroscopy

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