Finer gauge of cutting but not pencil-point needles correlate with lower incidence of post-dural puncture headache: a meta-regression analysis

Zorrilla‐Vaca, Andrés; Healy, Ryan; Zorrilla-Vaca, Carolina

doi:10.1007/s00540-016-2221-2

Cited by 18 publications

(26 citation statements)

References 41 publications

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“…Our meta‐regression analyses showed that the finer gauge‐cutting needle was associated with lower PDPH incidence but such correlation was not seen pencil‐point SNs. Our findings are in line with results from recent meta‐regression analyses by Zorrilla‑Vaca and colleagues, which included all surgical procedures employing neuraxial anesthesia . Zorrilla‑Vaca and colleagues also showed that needle gauge has a statistically significant correlation with a lower incidence of PDPH in cutting SNs, but not in pencil‐point SNs .…”

Section: Discussionsupporting

confidence: 91%

“…Our findings are in line with results from recent meta-regression analyses by Zorrilla-Vaca and colleagues, which included all surgical procedures employing neuraxial anesthesia. 49 Zorrilla-Vaca and colleagues also showed that needle gauge has a statistically significant correlation with a lower incidence of PDPH in cutting SNs, but not in pencil-point SNs. 49 Similarly, our findings are in line with a meta-analysis by Xu et al, which reported the superiority of pencil-point SNs over the cutting SN.…”

Section: Discussionmentioning

confidence: 93%

“…49 Zorrilla-Vaca and colleagues also showed that needle gauge has a statistically significant correlation with a lower incidence of PDPH in cutting SNs, but not in pencil-point SNs. 49 Similarly, our findings are in line with a meta-analysis by Xu et al, which reported the superiority of pencil-point SNs over the cutting SN. 50 However, it is important to note that our meta-analysis was comprehensive and included 20 RCTs compared with 9 RCTs addressing the role of SNs in obstetric patients.…”

Section: Discussionmentioning

confidence: 93%

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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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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 93%

See 1 more Smart Citation

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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“…Also, larger needle size (the bigger the gauge the smaller the needle) is correlated with an increased incidence of PDPH (27 gauge ranged 0-14% vs. 22-23 gauge ranged 8-25%). 10 But the size of the spinal needle may also cause technical difficulties such as bending and slow flow rates if the needle is too small. 10 A typical positional frontal or occipital headache that occurs within 72 h after spinal anesthesia is clinically considered as PDPH.…”

Section: Discussionmentioning

confidence: 99%

Our experience regarding patients with headache, vomiting, and urinary retention following endothermal ablation of the greater saphenous vein under spinal anesthesia: Gender type, age interval, and procedural risk factors are important

Bitargil

Kılıç

2020

Vascular

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Objectives The endovenous thermal ablation of the greater saphenous vein under spinal anesthesia is still a popular technique. Although this procedure is considered to be fast and simple, side effects such as headaches, vomiting, and urinary retention could occur. These side effects make the recovery period difficult for the patient. The patient’s age, gender, and procedural risk factors such as needle sizes and types are important parameters that affect the occurrence and rate of undesirable outcomes. This retrospective study aims to evaluate the endovenous thermal ablation method for the management of incompetent great saphenous veins under spinal anesthesia. Methods A total of 128 patients with incompetent varicose veins who were treated with an endovenous thermal ablation method under spinal anesthesia were retrospectively investigated between January 2016 and January 2019. The pre-, intra-, post-procedural, and follow-up data of the patients were collected and retrospectively compared. Results A total of 128 patients (69 males, 59 females; mean age 45.8 ± 11.8 years; range 21–71 years) were included in the study. The average preprocedural great saphenous vein diameters were 7.41 ± 18.8 mm (range: 5.5–13.0). The average ablated vein length was 25.3 ± 3.4 (range: 15–35) cm. The average tumescent anesthesia use was 300.9 ± 52.6 (range: 150–500) mL. The average procedure time was 18.2 ± 1.8 (range: 11–25) min. The venous clinical severity scores and the chronic venous insufficiency quality of life questionnaire scores declined significantly ( p for venous clinical severity scores: 0.001, p for chronic venous insufficiency quality of life questionnaire scores: 0.001). There was no postoperative paresis or paresthesia. There was one case of deep venous thrombosis and three cases of bruising. The total of three months’ occlusion rates was 96.9% (124/128). The overall post-dural puncture headache ratio was 18%. Women significantly suffered from more headaches than men (27% vs. 10%, p = 0.013). The extreme age intervals (pertaining to ages between 18 and 30 or 50+) were almost significantly less affected by headaches in comparison to the group with the age interval between 31 and 50 (11.3%, 24.2%, p: 0.056). A percentage of 12.5 patients suffered from vomiting. It was recorded that female patients suffered from vomiting more so than the males (20.3%, 5.8%, p: 0.013). Pertaining to vomiting, there was no significant difference between the two age interval groups ( p: 0.14). Urinary retention was observed in 6.3% of the patients. The female gender had a higher ratio of urinary retention, but the difference was insignificant. (8.5%, 4.3%, p: 0.46). There was no significant difference between the age interval groups in terms of urinary retention. Conclusions The endovenous thermal ablation of the greater saphenous vein under spinal anesthesia is a fast and effective treatment option for the management of incompetent saphenous veins. However, side effects such as headaches, vomiting, and urinary retention that are affected by gender types, age-intervals, and procedural characteristics should be kept in mind.

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“…Andres Zorilla-Vaca et al explained the lesser development of PDPH in the lateral decubitus position by the difference in CSF pressures in the sitting and lateral decubitus positions. 23 While CSF pressure is 40 cm H 2 O in the sitting position, this pressure falls to 5-20cm H 2 O in the lateral position. 24,25 Hypothetically, this high pressure is related to a larger puncture and longer leakage at a higher pressure.…”

Section: Discussionmentioning

confidence: 96%

<p>Is There An Effect On The Development Of Postdural Puncture Headache Of Dural Punction Made With The Spinal Needle In Three Different Orientations During Spinal Anaesthesia Applied To Pregnant Patients?</p>

Bıçak¹,

Salık²,

Akelma³

2019

JPR

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Background and objectives: Postdural punction headache (PDPH) is a well-known and common complication of spinal anesthesia. The relationship between spinal needle size, configuration and perforation characteristics of the spinal needle and non-essential leak continues to be controversial. Methods: This prospective-randomized study included 300 patients aged 18-45 years who underwent cesarean section under spinal anesthesia. Spinal anesthesia was performed using a 26G Quincke spinal needle in the L3-4, or L4-5 range in the sitting position. Spinal anesthesia was performed with spinal needle sharp tip opening in the Group 1 patients, right or left laterally in Group 2 and caudal in Group 3, transducing the dural fibers transversely to the subarachnoid area, and directing the free opening of the needle to the spine. The patients were visited in the clinic where they were hospitalized at the 24th and 48th hours postoperatively, and phoned on the 3rd and 5th days after discharge, being questioned for PDPH. Results: It was observed that 64% of patients with PDPH developed within the first 24 hrs, 24% between 24 and 48 hrs and 48-72 hrs in 12%. The incidence of PDPH was 14% in Group 1, 8% in Group 2 and 3% in Group 3. This difference between the groups was statistically significant (p: 0.019). The incidence of PDPH was lower in Group 3 than in Group 1 and Group 2. Conclusion: We suggest that when spinal anesthesia is applied in the obstetric patient group if needle opening faces caudal this method will reduce the frequency of PDPH.

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Finer gauge of cutting but not pencil-point needles correlate with lower incidence of post-dural puncture headache: a meta-regression analysis

Abstract: A significant relationship between needle gauge and subsequent rate of PDPH was noted in cutting needles, but not pencil-point needles.

Cited by 18 publications

References 41 publications

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

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

Our experience regarding patients with headache, vomiting, and urinary retention following endothermal ablation of the greater saphenous vein under spinal anesthesia: Gender type, age interval, and procedural risk factors are important

<p>Is There An Effect On The Development Of Postdural Puncture Headache Of Dural Punction Made With The Spinal Needle In Three Different Orientations During Spinal Anaesthesia Applied To Pregnant Patients?</p>

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