Influence of needle diameter on spinal anaesthesia puncture failures for caesarean section: A prospective, randomised, experimental study - 09/11/15
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Abstract |
Objectives |
Spinal anaesthesia represents the technique of choice for elective caesarean section. The purpose of this study was to compare the puncture failure rates with 25, 26 or 27gauge (G) pencil-point, Whitacre type (with introducer) needles during spinal anaesthesia for caesarean section.
Study design |
Prospective, randomised, experimental study in healthy subjects.
Patients and methods |
We recruited 330 adults, consecutively scheduled parturients, randomised into three groups. The subarachnoid puncture procedure was standardised. The flexibility of the three needle types was assessed in vitro, and a force was applied using a dynamometer. The occurrence of postdural puncture headache was also evaluated.
Results |
The number of spinal puncture failures was significantly higher in the 27G group, than in the 25G (P=0.006) group and the 26G (P<0.001) group, but did not differ between the 25G and 26G groups (P=0.606). Ten postdural puncture headaches were observed without significant differences among the groups.
Conclusions |
This prospective study showed that puncture failures occur less frequently with the use of 25G or 26G pencil-point needles as compared to 27G needles, probably due to the higher flexibility of the latter. This characteristic was demonstrated in vitro, in a reproducible model. This experiment suggests that a 26G pencil-point needle is the optimal gauge for performing spinal anaesthesia for scheduled caesarean sections.
Le texte complet de cet article est disponible en PDF.Keywords : Spinal anaesthesia, Caesarean section, Diameter, Needle, Failure, Postdural puncture headache
Plan
Vol 34 - N° 5
P. 277-280 - octobre 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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