Background:Radial artery cannulation is a common procedure in patients undergoing surgery requiring continuous hemodynamic monitoring. While the palpation method is widely practiced, its success may be influenced by patient-specific factors such as body habitus and pulse quality. This study aimed to evaluate the ease and success of radial artery cannulation using the palpation method and identify predictors of cannulation difficulty in adult surgical patients under general anaesthesia.

Methods:This prospective observational study was conducted on 92 adult patients undergoing elective surgery under general anaesthesia. Radial artery cannulation was performed using the palpation method by experienced anaesthesiologists. Data were collected on demographic variables, BMI, ASA class, pulse strength, number of attempts, time to successful cannulation, ease of cannulation, and complications. Subgroup analyses were conducted based on BMI and pulse strength. Binary logistic regression was used to identify independent predictors of difficult cannulation.

Results:First-attempt success was achieved in 68.5% of patients, with an overall success rate of 96.7%. The mean number of attempts was 1.45 ± 0.69, and the mean cannulation time was 62.4 ± 18.9 seconds. Difficult cannulation occurred in 15.2% of patients. Obese patients (BMI ≥30 kg/m²) had lower first-attempt success (42.9%) and higher rates of difficulty (35.7%; p = 0.009) compared to those with BMI <25 kg/m². Similarly, patients with weak radial pulse had significantly lower first-pass success (42.9%) and higher difficulty (42.9%; p < 0.001). Logistic regression identified BMI ≥30 kg/m² (AOR: 4.82, p = 0.020) and weak pulse (AOR: 7.26, p = 0.001) as independent predictors of difficult cannulation. Complications were observed in 9.8% of cases.

Conclusion:The palpation method remains a viable technique for radial artery cannulation, with high overall success in skilled hands. However, obesity and weak radial pulse are significant predictors of cannulation difficulty. Early identification of such factors should prompt consideration of ultrasound guidance to improve outcomes and reduce complications