Abstract
BackgroundPerforming spinal anaesthesia using the conventional popping method with a 27-gauge (27G) spinal needle is technically difficult. In this study, we compared the aspiration and conventional popping method for spinal anaesthesia using 27G Quincke-type needles.MethodsThis prospective, randomized study enrolled 90 patients, aged 19 to 65 years, with American Society of Anesthesiologists physical status I-III, who were undergoing spinal anaesthesia. Patients were randomly assigned to one of two groups using a computer-generated random number table: patients receiving spinal anaesthesia using the aspiration method, in which the needle is advanced with continuous aspiration, or the conventional popping method. The primary outcome measure was the success rate of the first attempt to perform dural puncture. Number of attempts and passages, withdrawal cases, successful attempt time, total procedure time, and actual depth of dural puncture were recorded.ResultsEighty-eight patients were included in the study. In the aspiration group, the success rate of first attempt for dural puncture was 93.3%, compared with 72.1% in the popping group (P = 0.019). Success involving needle withdrawal was recorded in 4 (8.9%) patients in the aspiration group and 13 (30.2%) in the popping group (P = 0.024). In the popping group, the number of attempts was significantly higher (P = 0.044), and total procedure time was significantly longer (P = 0.023). Actual depths of dural puncture were deeper in the popping group than in the aspiration group (P = 0.019).ConclusionsThe aspiration method using a 27G Quincke-type needle offers clinical benefits for dural puncture compared with the conventional popping method for spinal anaesthesia.Trial registrationClinical research information service number: KCT0002815, registered 21/Apr/2018. Retrospectively registered.
Highlights
Performing spinal anaesthesia using the conventional popping method with a 27-gauge (27G) spinal needle is technically difficult
Of the 90 patients enrolled in the present study, two patients in the popping group were excluded because dural puncture failed
The success rate of the first attempt for dural puncture was 93.3% compared to 72.1% in the popping group (P = 0.019)
Summary
Performing spinal anaesthesia using the conventional popping method with a 27-gauge (27G) spinal needle is technically difficult. We compared the aspiration and conventional popping method for spinal anaesthesia using 27G Quincke-type needles. PDPH is a common and troublesome complication; it is less likely to occur when using a thinner spinal needle [1, 2]. Using a thinner needle for spinal anaesthesia has several advantages. This procedure is more difficult to perform and prolonged [3,4,5]. Nerve damage or vascular injury may be caused by inserting the spinal needle too deep, due to uncertainty as to whether the dural puncture occurred
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