Comparison of Spinal Needle Deflection in a Ballistic Gel Model

Rand, Ethan; Christolias, George C.; Visco, Christopher J.; Singh, Jaspal

doi:10.5812/aapm.36607

Cited by 9 publications

(10 citation statements)

References 9 publications

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“…Rand claimed that Increased gauge (25 g) led to a significant increase in deflection among bevelled needles [16] but we found in practice that failure of needle placement is higher with very fine needle, perhaps due to bending of these needles, and in our study the rate of failure in the first attempt was higher with 27 gauge needles than 25 gauge needles.…”

Section: Discussioncontrasting

confidence: 63%

The Rate of Headache after Caesarean Section and the Size of Needle for Spinal Anesthesia: Clinical Trial

Khooshideh¹,

Shahriari²,

Bitarafan³

2017

Int J Neurorehabilitation Eng

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Section: Discussioncontrasting

confidence: 63%

The Rate of Headache after Caesarean Section and the Size of Needle for Spinal Anesthesia: Clinical Trial

Khooshideh¹,

Shahriari²,

Bitarafan³

2017

Int J Neurorehabilitation Eng

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“…3) The spinal needle type that is currently recommended for preventing PSH is a fine, pencil-point needle since it divides rather than cuts the dura mater fibers during puncture [8][9][10][11]. Notwithstanding the recommendation, some practical problems that have been reported with this type of needle and that have led to its lower preferability among practitioners include the following: (a) its fineness and flexibility result in the needle bending at the time of dural puncture [13]; (b) insufficient sharpness of its tip hinders the needle penetration through tissues; and (c) the need for an introducer complicates the procedure [8,12]. All simultaneously focus on either superiority of fine gauge non-cutting needles in regard traumatic dura mater injury or inferiority of these needles in regard to procedural issues.…”

Section: Discussionmentioning

confidence: 99%

“…However, due to their thin structure and length, click recognition has become more difficult than with large-gauge needles [4,5,12], and the incremental needle advancement technique needs to be applied [1]. With this technique, however, the needle may be advanced too far anteriorly in the neuraxial canal, touch a spinal nerve root, or even exit the dura sac on its anterior aspect without noticeable CSF return [13][14][15][16]. Design of fine-gauge spinal needles also eliciting well-perceived click sensation might be advantageous to lower the risk of PSH and increase accuracy of needle advancement.…”

Section: Introductionmentioning

confidence: 99%

Recognition and Differentiation of Dural Puncture Click Sensation: A Subjective and Objective Prospective Study of Dural Puncture Forces Using Fine-Gauge Spinal Needles

Utsumi

Hascilowicz

Omi

2021

Preprint

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Background: We hypothesized that the click perceived when puncturing the dura-arachnoid with fine-gauge spinal needles can be subjectively identified, and investigated whether it may be distinguishable among different needle types. Methods: Subjective and objective evaluations were performed. First, physicians punctured the polyamide film or porcine dura mater (n=70 and n=20, respectively) with seven types of spinal needles and numerically evaluated the perceived click sensations. Using an 11-point numerical rating scale (from “0” for “no click sensation” to “10” for “the strongest click perceived”) data, subjective differentiation among needle types was assessed. Second, in the objective part of the study, total forces elicited by polyamide film or porcine dura mater punctures with each needle were measured using a biomechanical testing device, and load-displacement curves evaluated. Third, the results of subjective and objective evaluations were compared. Results: All participants recognized the click and could discriminate among needles of different tip shape. The load-displacement curves for polyamide film and porcine dura mater were similar and needle-specific. The subjective numerical rating scale values corresponded well with the objectively measured changes in total forces ( R 2 = 0.862 and R 2 = 0.881 for polyamide film and porcine dura mater, respectively), indicating that an increase in the largest drop in total force value of 0.30 N or 0.21 N would produce an increase of numerical rating scale value of 1 for polyamide film and porcine dura mater, respectively. Conclusions: We provide an objective proof of the click sensation felt upon dural puncture using different fine-gauge spinal needles. Click recognition could be used as an additional indicator of successful spinal puncture.

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“…In this study, a Quincke needle was used. Further studies using Whitacre needles or another needle type with a wider diameter are needed (24). …”

Section: Discussionmentioning

confidence: 99%

Comparison of Successful Spinal Needle Placement Between Crossed-Leg Sitting Position and Traditional Sitting Position in Patients Undergoing Urology Surgery

2016

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BackgroundThe patient’s position during spinal anesthesia administration plays a major role in the success of spinal needle insertion into the subarachnoid space. The traditional sitting position (TSP) is the standard position for spinal anesthesia administration, but the success rate for spinal anesthesia administration in the TSP is still quite low. The crossed-leg sitting position (CLSP) is one of the alternative positions for the administration of spinal anesthesia, which can increase the degree of lumbar flexion.ObjectivesThis study aimed to compare successful spinal needle placement to patients in the CLSP and patients in the TSP prior to undergoing urology surgery.MethodsThis study was a non-blinded, randomized controlled trial in patients undergoing spinal anesthesia for urologic procedures from March-October, 2015 in the central national hospital Dr. Cipto Mangunkusumo, Indonesia. After obtaining approval from the FMUI – RSCM (Faculty of Medicine Universitas Indonesia – Rumah Sakit Dr. Cipto Mangunkusumo) Ethical Committee and informed consent from patients, 211 subjects were allocated into two groups: the CLSP group (n = 105) and the TSP group (n = 106). The proportion of successful spinal needle placement to the subarachnoid space, ease of landmark palpation, and the number of needle-bone contacts in both groups were then assessed and analyzed.ResultsThe rate of first-time successful spinal needle insertion was not significantly different between the CLSP and TSP groups (62.9% versus 55.7%, P > 0.05). Ease of landmark palpation in the CLSP group was not significantly different from that in the TSP group (86.7% versus 76.4%, P > 0.05). The number of needle-bone contacts in both groups were not significantly different (P > 0.05). The complication rates were similar in both groups.ConclusionsThe rate of successful spinal needle placement in the CLSP group was not significantly different from that in the TSP group in patients undergoing urology surgery. The CLSP can be used as an alternative sitting position for administration of spinal anesthesia.

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Comparison of Spinal Needle Deflection in a Ballistic Gel Model

Cited by 9 publications

References 9 publications

The Rate of Headache after Caesarean Section and the Size of Needle for Spinal Anesthesia: Clinical Trial

The Rate of Headache after Caesarean Section and the Size of Needle for Spinal Anesthesia: Clinical Trial

Recognition and Differentiation of Dural Puncture Click Sensation: A Subjective and Objective Prospective Study of Dural Puncture Forces Using Fine-Gauge Spinal Needles

Comparison of Successful Spinal Needle Placement Between Crossed-Leg Sitting Position and Traditional Sitting Position in Patients Undergoing Urology Surgery

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