Evaluation of 25-gauge Quincke and 24 — gauge Gertie Marx needles for spinal anaethesia for Caesarean section

Imarengiaye, CO; Edomwonyi, NP

doi:10.4314/eamj.v79i7.8843

Cited by 10 publications

(11 citation statements)

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“…In totally 6539 patients, 302 patients (4.6%) were reported having suffered from PDPH. [5,14,20–42] Two hundred sixteen of 3255 patients (6.6%) in cutting-point spinal needle group developed PDPH while 86 of 3284 patients (2.6%) in pencil-point spine needle group developed the same complication. Heterogeneity of the 25 studies were tested and showed no statistical significance ( P = 0.43; I 2 = 2%).…”

Section: Resultsmentioning

confidence: 99%

“…[7,9,43–45] It is more common in reproductive age group and pregnant females. [35] Of the 25 RCTs, 9 [20,26,30,33–35,38,40,41] were performed in obstetric patients. We made a subgroup to compare the frequency of PDPH in these peculiar patients.…”

Section: Resultsmentioning

confidence: 99%

“…The robustness of the result was tested by excluding these 4 studies, and no obvious change happened. Third, of all the studies, 14 [5,14,21,22,24,25,27,28,31,32,36,37,40,42] were performed in Europe, 6 [23,26,29,30,34,39] in North America, 4 [33,35,38,41] in Asia, and 1 [20] in Africa, reflecting a limitation of the evidence generalization. Lastly, all the documents were in English, meaning the possibility of language bias.…”

Section: Discussionmentioning

confidence: 99%

“…[20,21] Some studies argued that the incidence of PDPH was not significantly different between cutting-point and pencil-point needles [22,23] while some opposited, arguing noncutting needle lead to lower rate of headache. [24–26] A previous meta-analysis published in 2000 has compared the frequency of PDPH between Quincke (a cutting-point spinal needle) and pencil-point spinal needles which suggested that pencil-point spinal needle will significantly reduce PDPH rate compared with Quincke spinal needles.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of cutting and pencil-point spinal needle in spinal anesthesia regarding postdural puncture headache

et al. 2017

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Background:Postdural puncture headache (PDPH), mainly resulting from the loss of cerebral spinal fluid (CSF), is a well-known iatrogenic complication of spinal anesthesia and diagnostic lumbar puncture. Spinal needles have been modified to minimize complications. Modifiable risk factors of PDPH mainly included needle size and needle shape. However, whether the incidence of PDPH is significantly different between cutting-point and pencil-point needles was controversial. Then we did a meta-analysis to assess the incidence of PDPH of cutting spinal needle and pencil-point spinal needle.Methods:We included all randomly designed trials, assessing the clinical outcomes in patients given elective spinal anesthesia or diagnostic lumbar puncture with either cutting or pencil-point spinal needle as eligible studies. All selected studies and the risk of bias of them were assessed by 2 investigators. Clinical outcomes including success rates, frequency of PDPH, reported severe PDPH, and the use of epidural blood patch (EBP) were recorded as primary results. Results were evaluated using risk ratio (RR) with 95% confidence interval (CI) for dichotomous variables. Rev Man software (version 5.3) was used to analyze all appropriate data.Results:Twenty-five randomized controlled trials (RCTs) were included in our study. The analysis result revealed that pencil-point spinal needle would result in lower rate of PDPH (RR 2.50; 95% CI [1.96, 3.19]; P < 0.00001) and severe PDPH (RR 3.27; 95% CI [2.15, 4.96]; P < 0.00001). Furthermore, EBP was less used in pencil-point spine needle group (RR 3.69; 95% CI [1.96, 6.95]; P < 0.0001).Conclusions:Current evidences suggest that pencil-point spinal needle was significantly superior compared with cutting spinal needle regarding the frequency of PDPH, PDPH severity, and the use of EBP. In view of this, we recommend the use of pencil-point spinal needle in spinal anesthesia and lumbar puncture.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of cutting and pencil-point spinal needle in spinal anesthesia regarding postdural puncture headache

et al. 2017

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“…Sixty percent (12/20) of studies employed blinding. 50% (6/12) of these studies blinded only the outcome assessors while three studies blinded the outcome assessors, patients and investigators, 23,40,41 and two studies blinded only patients. 3,40 The study by Baig and colleagues blinded patients and investigators.…”

Section: Blindingmentioning

confidence: 99%

Impact of spinal needle type on postdural puncture headache among women undergoing Cesarean section surgery under spinal anesthesia: A meta‐analysis

Lee

Sandhu

Djulbegoviĉ³

et al. 2018

J Evidence Based Medicine

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Needle gauge and tip designs for preventing post-dural puncture headache (PDPH)

Arévalo-Rodríguez

Muñoz

Godoy‐Casasbuenas

et al. 2017

Cochrane Database of Systematic Reviews

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There is moderate-quality evidence that atraumatic needles reduce the risk of post-dural puncture headache (PDPH) without increasing adverse events such as paraesthesia or backache. The studies did not report very clearly on aspects related to randomization, such as random sequence generation and allocation concealment, making it difficult to interpret the risk of bias in the included studies. The moderate quality of the evidence for traumatic versus atraumatic needles suggests that further research is likely to have an important impact on our confidence in the estimate of effect.

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Evaluation of 25-gauge Quincke and 24 — gauge Gertie Marx needles for spinal anaethesia for Caesarean section

Cited by 10 publications

References 0 publications

Comparison of cutting and pencil-point spinal needle in spinal anesthesia regarding postdural puncture headache

Comparison of cutting and pencil-point spinal needle in spinal anesthesia regarding postdural puncture headache

Impact of spinal needle type on postdural puncture headache among women undergoing Cesarean section surgery under spinal anesthesia: A meta‐analysis

Needle gauge and tip designs for preventing post-dural puncture headache (PDPH)

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