Separated Spinal Needle Shaft from the Hub during Subarachnoid Block: A case report

Abstract

We report a case of in which the separation of a spinal needle shaft from a hub during subarachnoid block required surgical removal of the retained shaft. A 26-year-old male was scheduled for a transurethral resection of a bladder tumor under spinal anesthesia. A 25-gauge Quincke needle was selected. The needle was advanced to the junction of the hub and the L3-4 interspace through a midline approach, but the subarachnoid space was not identified. When the needle was withdrawn to change of direction of needle tip, the needle shaft separated from the hub. The separated needle shaft was palpable under the patient's skin, but it's removal using a Kelly through a small incision was impossible. Under the radiographic guidance, the needle was removed after several attempts. We emphasize importance of checking epuipment prior to a subarachnoid block and the use of a careful procedure to reduce complications associated with a faulty spinal needle.