Frequency, Causes, and Complications of Re-Cannulation after Peripheral Intravenous Catheterization in Surgical Patients: A Cross-Sectional Study

Re-Cannulation in Surgical Patients

Abstract

Objective: To determine the cannula sizes used and to assess the frequency, causes, and complications of re-cannulation among surgical patients admitted to Pakistan Institute of Medical Sciences (PIMS), Islamabad.

Methodology: A cross-sectional study was conducted in the Department of General Surgery, PIMS, Islamabad, from January to March 2025. Patients aged 14–75 years requiring peripheral intravenous access were included, while those referred with pre-existing intravenous lines were excluded. Data collected included demographic characteristics, comorbidities, cannula size, insertion site, infusion setting, catheter dwell time, and catheter-related complications such as pain, swelling, inflammation, infiltration, and extravasation. Patients were monitored daily until catheter removal. Descriptive statistics were generated using SPSS version 27, and associations between complications and clinical variables were analyzed using the chi-square test with a significance level of p < 0.05.

Results: A total of 225 patients were enrolled, with a mean age of 43.96 ± 17.1 years; 64% were male. Re-cannulation was required in 104 patients (46.2%), most commonly due to pain and swelling. The 20-gauge cannula was the most frequently used (50.2%), followed by the 18-gauge cannula (35.5%). Most catheters (94.2%) had a dwell time of less than four days. The arm was the most common insertion site (52%), followed by the hand (32.8%). Patient age, catheter dwell time, and insertion site showed significant associations with catheter-related complications.

Conclusion: Re-cannulation following peripheral intravenous catheterization is common among surgical patients and is predominantly associated with pain, swelling, and inflammation. Patient age, catheter dwell time, and insertion site are key factors influencing complication rates. These findings highlight the need for careful site selection, appropriate cannula sizing, and vigilant catheter monitoring to reduce complications and improve patient comfort.