This study compares two different standing positions of the doctor while inserting a central venous catheter into a neck vein using ultrasound guidance. It aims to find whether the doctors position affects the needle tip location and the chance of successful catheter insertion on the first attempt.

INTERVENTION: Intervention1: Left axillary position: The operator will stand at the patients left axillary line to perform the left internal jugular vein catheterization and the total duration of such intervention is 20‐25 minutes Control Intervention1: Conventional cephalad position: The operator will stand at the conventional cephalad position, at the patients head, to perform the left internal jugular vein catheterization and the total duration taken to perform the procedure is 25‐30 minutes CONDITION: Health Condition 1: O‐ Medical and Surgical PRIMARY OUTCOME: distance between the center of the Internal Jugular Vein and the needle tip after needle puncture is measured in milimeters and the first attempt success rate between the two groupsTimepoint: Distance from the needle tip is continuously measured after skin puncture till it punctures the vessel at 0,1,2,3,4,5,10,15,20,30,60seconds SECONDARY OUTCOME: To compare the overall time taken for successful guidewire insertion ; To compare the number of skin punctures & needle redirections ; To observe & compare the incidence of complicationsTimepoint: Monitoring of time taken in skin puncture & then needle redirections & time taken overall in successful guidewire insertion at o,1,2,3,4,5,10 minutes & monitoring of any complications & adverse events if happen till 24 hours INCLUSION CRITERIA: Adult patients aged 18‐60 years of either se Xscheduled for elective cardiothoracic surgery. Patients willing to give written and informed consent. Patients belonging to the American Society of Anesthesiologists (ASA) grades 1 & II