Evaluation of Tip Holed Spinal Needle - A Comparative Study

Abstract

Background: The performance and post dural puncture headache were assessed in this randomised clinical study.

Methods. Total 100 patients of ASA physical status I and II undergoing elective caesarean section were enrolled for the study. Patients in the controlled group Group-A. Patients in the trial group (Group-B).

ABSTRACT: Regional block has its own unique place in modem anesthetic practice increasing popularity over 30-40 years has followed better understanding of the technique and acceptance than the incidence of side effects is tow. These depend not only on the correctly performed procedures but the correct design of the needle is also important. The purpose of this clinical study is to evaluate the performance of tip hole spinal needle (25G) in comparison with widely used Quincke spinal needle (25G). Clinical effects, performers satisfaction, side effects and complications were assessed over 100 pts who were decided into group A (Qiuncke gr) & Group B (tip hole gr) undergoing emergency & elective C.S. under spinal anaesthesia. Ease of insertion of the needle, number of attempts for successful insertion, appearance of CSF flow through needle, bending of needle, quality of analgesia, clinical effects & PDPH were assessed.

No significant changes in pulce, BP. & SPO2 in 1 minute & 5 minuets were found in pre-operative & per-operative period in Group A & also in Group B.

In terms of ease of insertion there was no significant change in Group A (100%) & Group B (90%). It was found that in less than 1 second no CSF fluid appeard in Group A but in Group B, CSF appeard in 30%, in less than 2 seconds, the values among Gr A & Gr B were 4% & 52%, in less than 3 seconds. 50% & 18% respectively. In less than 4 seconds & 5 seconds in Group A 38% & 8% respectively and no CSF fluid appeard in Group B in that period.

In Group A 52% cases required 1 attempt, 28% cases 2 attempts, 16% of cases 3 attempts & 4% cases 4 attempts were required. In Group B it was 86%, 14% & no 3rd & 4th attempts required. In terms of bending of needles during insertion, the performance of Group B was better (7% in Group A and no in Group B). The incidence of PDPH was found absolutely nil among the gr B & negligible (2%) in gr A subjects.

Journal of BSA, Vol. 18, No. 1 & 2, 2005 p.3-8