Jugular Veins

This observational study aims to learn whether changes in the internal jugular vein during anesthesia induction can help predict low blood pressure and kidney injury after surgery. The main questions it aims to answer are: 1. Can the internal jugular vein collapsibility index before anesthesia predict low blood pressure during induction? 2. Can the change in internal jugular vein collapsibility from before to just after anesthesia predict low blood pressure during surgery and acute kidney injury after surgery? Participants will have routine ultrasound scans of the neck before anesthesia and again shortly after they fall asleep for surgery. Researchers will also record blood pressure during surgery and measure kidney function after surgery using routine blood tests. and again shortly after they fall asleep for surgery. Researchers will also record blood pressure during surgery and measure kidney function after surgery using routine blood tests.

Two approaches such as ultrasound (US)-guided and prelocation techniques are possible when the internal jugular vein cannulation is attempted with US. This study is a clinical trial that compares the success rates of both techniques and shows the non-inferiority of the prelocation technique. However, during prelocation technique, rotated screen of the US is used instead of original screen. The angle of rotation is determined by the degree of rotation of US probe where an accelerometer is attached.

Two approaches are possible when the first finder needle attempt of the internal jugular vein cannulation fails; the needle can be turned slightly laterally or the puncture point can be moved slightly medially. This study is an ultrasonographic stimulation study to evaluate the success rate of turning the needle laterally and moving the puncture point medially, and to determine the proper angle or distance for the second try of internal jugular vein cannulation.