High success rate and low incidence of headache and neurological symptoms with two spinal needle designs in children*

Kokki, Hannu; Turunen, M; Heikkinen, Markku; Reinikainen, Matti; Laisalmi, Merja

doi:10.1111/j.1399-6576.2005.00837.x

Cited by 33 publications

(43 citation statements)

References 19 publications

(39 reference statements)

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“…Of the 25 RCTs, 15 [5,14,21,23–25,27–31,38–41] reported the severity of PDPH which could be graded as mild or severe. These 15 studies enrolled 3570 patients, with 1854 patients in cutting spine needle group and 1716 patients in pencil-point spine needle group.…”

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%

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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: Discussionmentioning

confidence: 99%

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

et al. 2017

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“…However, these data are confounded because spinal anaesthesia is usually performed by doctors with more experience than many of the doctors doing diagnostic LPs. Four randomised trials in children having spinal anaesthesia with 24-gauge or smaller needles found little evidence of a difference in the rate of LP headache between different needle sizes and needle designs 10 12 14 15. The benefit, if any, of using 25-gauge needles for LPs compared with the standard 22-gauge needle therefore remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Headache after lumbar puncture: randomised crossover trial of 22-gauge versus 25-gauge needles

et al. 2013

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“…Çocuk-larda spinal iğne tercihinde keskin uçlu ve kalem uçlu iğnelerin benzer başarı oranları olduğunu belirten yayınlar mevcuttur. [7][8][9] Apilioğulları ve ark.nın 414 pediatrik hastada yapmış oldukları ça-lışmada, baş ağrısı oranı keskin uçlu iğnelerle %4,5, kalem uçlu iğnelerle ise %0,4 olarak belirtilmiştir. 10 Çalışmamızda 26 G keskin uçlu iğne kullanılmış ve hastalarımızın hiçbirinde baş ağrısı tespit edilmemiştir.…”

Section: Discussionunclassified

Our Experiences with Spinal Anesthesia in 143 Pediatric Patients

Kantekin¹,

Yalvaç²,

Evran³

et al. 2015

Turkiye Klinikleri J Anest Reanim

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Ö ÖZ ZE ET T AAm ma aç ç: : Spinal anestezi, erişkinlerde olduğu kadar çocuklarda da popularitesi artan bir tekniktir. Hızlı başlangıçlı sensöriyel blok ve tam bir kas gevşemesi sağlaması, aynı zamanda cerrahiye stres yanıtın ve kardiyovasküler yanıtın da kontrol edilebilmesi nedeni ile çocuk cerrahisinde popularitesini artırmıştır. Bu çalışmanın amacı, spinal anestezi uyguladığımız hastalarda bu tekniğin etkinliğini, yan etkilerini ve komplikasyonlarını geriye dönük olarak değerlendirmektir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Yaşları 7-14 yıl arasında değişen 143 spinal anestezi ile opere olmuş çocuk hastanın verileri geriye dönük olarak incelendi.Hastaların bireysel özellikleri, operasyon türleri, cerrahi süre, motor bloğun gerileme süresi ve komplikasyonlar kaydedildi. B Bu ul lg gu ul la ar r: : Hastaların 47'si kız, 96'sı erkek; yaş ortalaması 10,6±1,9 yıl idi. Yüzde 98'inde ilk girişimde olmak üzere başarılı spinal anestezi sağlandı. Hastaların %17,4'ünde operasyon sırasında ek intravenöz sedasyon gereksinimi oldu. Yüzde %88,8'inde midazolam ile yeterli intraoperatif sedasyon sağlanırken, 16 hastada aralıklı olarak propofol ile sedasyon sağlanmıştı. Başlıca önemli yan etkinin 8 ve 10 yaşlarındaki iki hastada görülen ve kardiyovasküler stabilitenin korunduğu gözlenen yüksek spinal blok olduğu görüldü. Dokuz yaşındaki bir hastada düşük ayak gelişti, ancak medikal tedavi ve bir aylık fizik tedavi programı ile tam iyileşme sağlandı ve taburcu edildi. Spinal anestezi ile ilişkili kardiyovasküler kollaps, total spinal blok, intravasküler enjeksiyon gibi ciddi yan etkilere rastlandı. Spinal anestezi uygulamasının en fazla akut batın tanısı ile acil cerrahi planlanmış 102 hastaya yapıldığı görüldü. S So on nu uç ç: : Çocuklarda spinal anestezi özellikle acil vakalarda genel anesteziye tercih edilebilecek bir tekniktir. Ancak güvenli ve etkin şekilde uygulanabilmesi için komplikasyonlarının ve olumlu sonuçlarının belirtildiği yayınlara ihtiyaç olduğunu düşünüyoruz.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Çocuk; anestezi, spinal A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The popularity of spinal anesthesia in pediatric surgery has increased since it produces a uniformly distributed sensory block with rapid onset and good muscle relaxation, as well as resulting in complete control of cardiovascular and stress responses. The aim of this study was to evaluate the characteristics of spinal anesthesia, including its efficacy, adverse effects and complications. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : The datas of the 143 children aged between 7-14 years who had been operated with spinal anesthesia were evaluated retrospectively. The demographic characteristics, type of operation, length of surgery, time to regression of motor block and complications are recorded. R Re e--s su ul lt ts s: : 47 of the patients were girls, 96 of the patients were boys and the mean age of the patients was10.6±1.9. 98% of patients had successful block at the first attempt. Ad...

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High success rate and low incidence of headache and neurological symptoms with two spinal needle designs in children*

Abstract: Both needles were associated with a high success rate and a low incidence of complaints.

Cited by 33 publications

References 19 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

Headache after lumbar puncture: randomised crossover trial of 22-gauge versus 25-gauge needles

Our Experiences with Spinal Anesthesia in 143 Pediatric Patients

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