Safety of fine-gauge, pencil point spinal needles (original) (raw)
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The PENCAN 25-gauge needle: A new pencil-point needle for spinal anesthesia tested in 1,193 patients
Regional Anesthesia and Pain Medicine, 1999
Background and Objectives. The PENCAN 25-gauge spinal needle is a new pencil-point needle with an inner diameter of 0.32 mm resulting in a relatively high cerebrospinal fluid (CSF) flow. The PENCAN 25-gauge needle was tested for ease of identification of a successful dural puncture, the failure rate of spinal anesthesia, and the inddence of postdural puncture headache (PDPH). Methods. In a multicenter trial, the needle was tested in patients undergoing spinal anesthesia. A questionnaire evaluated the characteristics of the dural puncture. A second questionnaire was used to assess postspinal side effects (PDPI-I, atypical headache, audiovisual disturbances). Results. In 1,193 patients, dural puncture was evaluated as easy in 85.2%, as moderate in 6.2%, as difficult in 6.7%, and as impossible in 1.9%. Needle performance was assessed as excellent or satisfactory in 96.9%. In 95.9% of patients, CSF appeared within 2 seconds. A perceptible "click" was noticed in 78.4% of patients. In 1.9%, CSF could not be obtained, because of spine deformities, obesity, or bending of the needle. In 1,166 patients, postpuncture complaints were evaluated, involving 635 women (54.5 %), 773 patients (66.3 %) under the age of 50 years old, and 170 (14.6 %) cesarean deliveries. The overall inddence of PDPH was 1.3% (n = 15). A bloodpatch was needed in five patients. After cesarean delivery the incidence of PDPH was 3.4%, all responding to conservative treatment. Atypical headache and isolated audiovisual disturbances occurred in 7.5% and 1.5% of patients, respectively. Conclusions. A failure rate of 1.9% together with a 1.3% incidence of PDPH were comparable to other 25-gauge pendl-point needles. The rapid appearance of CSF and a perceptible "dick" made prompt recognition of successful dural puncture possible.
Rate of injection through Whitacre needles affects distribution of spinal anaesthesia
British Journal of Anaesthesia, 2001
A prospective, randomized, double-blind study was performed to investigate whether altering the rate of injection of local anaesthetic through a Whitacre needle had any effect on the spinal block achieved. Twenty patients scheduled for elective urological surgery under spinal anaesthesia received an injection of 3 ml of 0.5% plain bupivacaine either by hand (fast) over 10 s (18 ml min ±1) or by infusion pump (slow) over 3 min (1 ml min ±1). All patients were in the sitting position both during insertion of the spinal needle and for 3 min after the start of spinal injection, and they then changed to the supine position. The slow injection group achieved peak sensory block earlier, after a median interval of 20 (95% con®dence interval 12.5±30) min vs 30 (22.5±45) min (P<0.05) for the fast group. The level of peak sensory block was similar: T3.5 (T2±T4.5) vs T4 (T1.5±T6.5). The time to lowest mean arterial pressure occurred earlier in the slow group, at 10 (8 to 18) vs 20 (15±31) min (P<0.05). Duration of the motor block was shorter in the slow group: 180 (152±242) vs 270 (225±300). We conclude that a slow spinal injection of plain bupivacaine results in a block of more rapid onset and recovery.
Spinal needle with prefilled syringe to prevent medication error: A proposal
In this context, particularly to prevent the medication errors during the intrathecal administration of local anaesthetics, we propose to change the presentation and packaging of the appliances and agents used for this purpose. One spinal needle with a syringe prefilled with the local anaesthetic agents may be marketed in a single blister pack, which will be peeled open and presented before the anaesthesiologist conducting the procedure. This presentation might not only reduce the medication mis-identification, it could also have a significant role in infection control. Bupivacaine hydrochloride is found to be stable in polypropylene syringes and can be utilised; the product will not become much expensive. Experiments on prolongation of stability of hyperbaric local anaesthetics in polypropylene syringes and specific recommendations for preservation protocols may be required.
2014
He belongs to the Institutos Nacionales de Salud as associated researcher. He has more than 130 publications on anesthesia, pain, internal medicine and critical care journals/books. He has been a member of various editorial committees in anesthesiology journals, and was chief editor of the journal Anestesia en México. Dr. Whizar-Lugo is the founding director and current president of Anestesiología y Medicina del Dolor, a free medical educative program on the internet.
The effect of Pencan needle orientation on spinal anesthesia outcomes
AANA journal, 2005
Slow resolution of block and incidence of side effects deter many practitioners from choosing spinal anesthesia for out-patient surgical procedures. Some studies suggest that controlling bevel or side port orientation of a spinal needle during anesthetic injection can affect occurrence of side effects and time to block resolution. The objective of this study was to determine the effects of varying Pencan spinal needle (B-Braun, Bethlehem, Pa) side port orientations on duration of block and incidence of side effects in groups of patients receiving spinal anesthesia. We randomized 87 subjects scheduled for spinal anesthesia to receive a spinal anesthesia injection using a cephalad, lateral, or caudad side port orientation. Onset, duration, block height, incidence of side effects, and analgesic requirements were among the variables measured. No difference in onset, duration, or analgesic requirements was noted among groups. Differences were noted in time to discharge from the hospital ...
Lecture Notes: Clinical Anaesthesia
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spinal anesthesia and opioid additive
First of all I dedicate this book to the great Allah who help me to do this work secondly I dedicate this work to my parents and to my women colleagues .and advise them to take broader steps as men colleagues in scientific working and help our communities grow up in all fields.
Translational Research in Anatomy, 2021
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