Background and objectives: Skin fragments during lumbar punctures may develop intraspinal epidermoid tumors. The aim of this study was to determine the incidence of epithelial cells that refl ow along with the fi rst and third drops of CSF of patients undergoing spinal anesthesia. Methods: Samples of the fi rst and third drops of cerebrospinal fl uid were collected from 39 adult patients undergoing spinal anesthesia with a 25G Quincke needle. Four microscope slides were prepared: one for the fi rst drop, one for third drop, one for the needle, and one with a drop of saline for control. A pathologist examined the slides randomly. Results: Squamous epithelial cells were identifi ed in 35 (89.7%) samples from the fi rst drop, 34 (87.2%) from the third drop, and 24 (61.5%) from spinal needle. The third drop showed a mean number of cells larger than the fi rst drop (p = 0.046). Nucleated epithelial cells were found in a sample of the fi rst drop (2.56%), in four samples of third drop (10.25%), and in one spinal needle (2.56%). Third drop showed a mean number of nucleated cells higher than fi rst drop with no statistical difference (p = 0.257). Conclusions: High percentage of epithelial cells was found in the fi rst (89.7%) and third (87.2%) drops of CSF refl ow and in used needles (61.5%). Skin cells were found even using small gauge disposable needles with well-adapted mandrel,
High percentage of epithelial cells was found in the first (89.7%) and third (87.2%) drops of CSF reflow and in used needles (61.5%). Skin cells were found even using small gauge disposable needles with well-adapted mandrel.
ResumenJustifi cativa e objetivos: Algunos fragmentos de piel durante las punciones subaracnoideas pueden desarrollar tumores epidermoides intraespinales. El objetivo de este estudio fue verifi car la incidencia de células epiteliales que refl uyen junto con la primera y tercera gotas de líquido cefalorraquídeo de los pacientes sometidos a la raquianestesia. Método: Se obtuvieron muestras de la primera y tercera gotas de líquido cefalorraquídeo en 39 pacientes adultos sometidos a la raquianestesia con una aguja 25G Quincke, siendo confeccionadas cuatro láminas: de la primera gota, de la tercera gota, de la aguja y una cuarta lámina control con una gota de suero fi siológico. Las láminas fueron examinadas de forma aleatoria por el patólogo. Resultados: Se identifi caron células epiteliales escamosas en 35 (89,7%) de las muestras de la primera gota, en 34 (87,2%) de la tercera gota y en 24 (61,5%) de las agujas espinales. La tercera gota tuvo como promedio un mayor número de células que la primera gota (p = 0,046). Las células epiteliales nucleadas fueron encontradas en una (2,56%) de las muestras de la primera gota, en cuatro (10,25%) de la tercera gota y en una (2,56%) de las agujas espinales. La tercera gota presentó como promedio, un mayor número de células nucleadas que la primera gota sin diferencias estadísticas (p = 0,257). Conclusiones: Encontramos un alto porcentaje de células epiteliales que refl uyen en la primera (89,7%) y en la tercera (87,2%) gotas del líquido cefalorraquídeo y en las agujas utilizadas (61,5%). Y aunque hayamos usado agujas de pequeño calibre, desechables y con un mandril bien adaptado, se encontraron células de la piel.
High percentage of epithelial cells was found in the first (89.7%) and third (87.2%) drops of CSF reflow and in used needles (61.5%). Skin cells were found even using small gauge disposable needles with well-adapted mandrel.
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