Vascular trauma associated with routine spinal anaesthesia.
Samples of cerebrospinal fluid obtained from 130 patients undergoing spinal anaesthesia were examined microscopically. Subarachnoid puncture was performed using either a 25G Whitacre or 25G Quincke spinal needle. Two samples were collected from each patient and the red blood cell count of the second sample collected was taken as a measure of the vascular trauma associated with the procedure. Red blood cells were seen in 50 (38%) of these samples, of which 18 (14%) contained > 100 red blood cells.mm-3. Paraesthesia was felt by 11 (8.5%) patients and the occurrence of paraesthesia was associated with significantly raised red blood cell counts (p < 0.0001). There was also a correlation between the number of needle passes made at lumbar puncture and the red blood cell count in the sample (p < 0. 0001). Neither spinal needle type nor antiplatelet drug therapy influenced red blood cell counts (p = 0.66 and 0.37, respectively). These findings suggest that routine spinal anaesthesia is often complicated by minor degrees of vascular trauma, especially when paraesthesiae or technical difficulty occur at subarachnoid puncture.
Department of Anaesthesia, Blackpool Victoria Hospital, UK.
P R
PR
Knowles
N P
NP
Randall
A S
AS
Lockhart
D000368:Aged; D000369:Aged, 80 and over; D000775:Anesthesia, Spinal / Q000009:adverse effects* / Q000295:instrumentation; D004906:Erythrocyte Count; D005260:Female; D006801:Humans; D008297:Male; D009339:Needles; D010292:Paresthesia / Q000134:cerebrospinal fluid*; D013129:Spinal Puncture / Q000009:adverse effects* / Q000295:instrumentation; D013346:Subarachnoid Space / Q000098:blood supply; D014950:Wounds, Penetrating / Q000134:cerebrospinal fluid*