Administering Bolus Intravenous Norepinephrine to Improve the Peripheral Arterial Line Cannulation: Randomized Controlled Trial
Issued Date
2026-07-01
Resource Type
ISSN
01252208
eISSN
24081981
Scopus ID
2-s2.0-105044939262
Journal Title
Journal of the Medical Association of Thailand
Volume
109
Issue
7
Start Page
612
End Page
617
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of the Medical Association of Thailand Vol.109 No.7 (2026) , 612-617
Suggested Citation
Prachanpanich N., Morakul S., Rojanasiripong W., Kiatmongkolkul N. Administering Bolus Intravenous Norepinephrine to Improve the Peripheral Arterial Line Cannulation: Randomized Controlled Trial. Journal of the Medical Association of Thailand Vol.109 No.7 (2026) , 612-617. 617. doi:10.35755/jmedassocthai.2026.7.03618 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/118224
Title
Administering Bolus Intravenous Norepinephrine to Improve the Peripheral Arterial Line Cannulation: Randomized Controlled Trial
Author's Affiliation
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: The conventional arterial line insertion may pose challenges in some cases. The methods to enhance the success rate of arterial line cannulation require specific equipment and skill, in contrast to the conventional palpation technique. Objective: To investigate whether administering intravenous norepinephrine as a bolus dose can increase the success rate of arterial line insertion using the conventional technique. Materials and Methods: The randomized study included adults undergoing elective surgery and requiring the perioperative arterial line insertion. The participants were allocated into two groups: the experimental norepinephrine group (NE group) received five mcg of norepinephrine intravenously, and the control group (NSS group) received an intravenous saline solution before inserting the arterial line. The primary outcome was the difference in the number of puncture attempts. The secondary outcomes included the total time to successful arterial cannulation and complications related to the procedure. Results: Ninety-two patients were randomized and analyzed, with 46 in the NE group and 46 in the NSS group. There was a significantly lower in the number of arterial puncture attempts in the NE group than the NSS group (p=0.034), demonstrating a notably higher first-attempt success rate [29 (63%) vs. 25 (54.3%)] and fewer patients required more than two attempts [3 (6.5%) vs. 12 (26.1%)]. The time to successful arterial line cannulation was significantly lower in the NE group compared to the NSS group [124 (59-227) seconds vs. 184 (92-480) seconds, p=0.028]. Furthermore, the results also demonstrated a significantly lower incidence of complications in the NE group compared to the NSS group [8 (17.4%) vs. 20 (43.5%), RR 0.400, 95% CI 0.197 to 0.814, p=0.007]. Conclusion: Intravenous norepinephrine administration before the conventional arterial line insertion can reduce the number of attempts required, decrease total time to success, and lower the incidence of complications related to the arterial line insertion.