Efficacy of Ultrasound-Guided versus Landmark Technique in Central Venous Catheterisation: A Prospective Comparative Study

Background: Central venous catheterisation is an essential procedure in anaesthesia, emergency care, and intensive care practice, but landmark-guided insertion is associated with failed attempts and mechanical complications. Ultrasound guidance allows real-time visualisation of vascular anatomy and needle trajectory, improving procedural precision. The objective is to compare ultrasound-guided and landmark techniques for central venous catheterisation with respect to first-attempt success, overall success, number of attempts, catheterisation time, need for change of site, and procedure-related complications. Material and Methods: This prospective comparative study included 60 patients requiring central venous catheterisation at Kamineni Institute of Medical Sciences, Narketpally, Telangana, India, from December 2024 to November 2025. Patients were divided equally into Group U, who underwent ultrasound-guided catheterisation, and Group L, who underwent landmark-guided catheterisation. Baseline characteristics, indication, insertion site, procedural outcomes, and complications were recorded and compared between the two groups. Results: Baseline demographic and clinical variables were comparable. First-attempt success was higher in Group U than Group L. The mean number of attempts and mean catheterisation time were lower with ultrasound guidance. Overall success was 100.0% in Group U and 90.0% in Group L. Any complication occurred in 3.3% of patients in Group U and 26.7% in Group L. Conclusion: Ultrasound-guided central venous catheterisation demonstrated superior procedural efficacy and safety compared with the landmark technique. Its use was associated with higher first-pass success, fewer attempts, shorter procedure time, and fewer mechanical complications.

Keywords: Central venous catheterisation; ultrasound guidance; landmark technique; first-attempt success; mechanical complications; intensive care; anaesthesia.