Efficiency of Using a Fixed-Wrist Splint in Patients with Intra-Arterial Catheterization to Monitor Arterial Blood Pressure During a Surgical Intervention: A Pilot Study

Abstract

OBJECTIVES: This study is a pilot research with objectives to study the effectiveness of using a fixed-wrist splint in patients undergoing intraarterial catheterization to monitor the patient’s arterial blood pressure from the artery at the wrist during surgery and to assess the anesthesiologists’ satisfaction in using the fixed-wrist splint.

MATERIALS AND METHODS: This study was conducted as a pilot case series describing the use of a fixed-wrist splint designed to be suitably inclined to between 30° and 40° during intra-arterial catheterization in surgical procedures. The sample was 8 patients undergoing surgery with intra-arterial catheterization at the wrist, and 8 anesthesiologists who used the fixed-wrist splint during the procedures completed the satisfaction questionnaire. The study was conducted between 22 October 2021 and 4 February 2023. The effectiveness was measured by monitoring the count of the arterial line dislodgement, the number of catheter reinsertion, the ability to consistently monitor the blood pressure effectively, and the satisfaction of anesthesiologists that used the device. Data were summarized using descriptive statistics. Continuous variables were presented as median and interquartile range, while categorical variables were presented as frequency and percentage.

RESULTS: A total of 8 patients were included. The median age of the patients was 57 years (IQR 52.5–68.5). The median body weight was 64.6 kg (Interquartile Range (IQR) 59.6–71.4), the median height was 166.5 cm (IQR 159.5–171.0), the median wrist circumference was 16.25 cm (IQR 15.75–16.5). Among the five patients with available measurements, the median wrist-splint angle was 33° (IQR 31–36°). Six of the patients were male (75%), and two were female (25%). Six of the patients underwent heart surgery (75%), and 2 of the patients underwent neurosurgery (25%). Of all the patients who used the fixed-wrist splint, 100% experienced no arterial line dislodgement, 100% required no catheter reinsertion, and blood pressure was monitored successfully in all cases (100%). Additionally, 8 anesthesiologists reported high satisfaction with the device. Median item scores ranged from 4 to 5 across the six satisfaction domains, with the highest score observed for safety [5 (IQR 5–5)]. The median total satisfaction score was 27.5 out of 30 (IQR 25.0–29.3), and all respondents were willing to continue using the device (100%).

CONCLUSION: In this pilot case series, the use of the fixed-wrist splint in patients undergoing intra-arterial catheterization was feasible. No arterial line dislodgement or catheter reinsertion occurred, and continuous arterial blood pressure monitoring was successfully maintained in all cases. Additionally, anesthesiologists were satisfied with the device, especially regarding safety, practicality, and the benefit of using the fixed-wrist splint.