[Comparison of efficacy and complications of 27G and 29G Sprottte needles for subarachnoid anesthesia].
OBJECTIVE
Post-dural puncture headache and lumbar backache are related to needle gauge and type of point used. We aimed to determine whether the incidence of post-dural puncture headache and lumbar backache could be reduced by using fine gauge pencil-point Sprotte 27G and 29G needles. We also studied increases in technical difficulty with these needles and whether or not reducing needle gauge affected anesthetic quality.


METHODS
Three hundred eighty-nine patients undergoing orthopedic or lower abdominal surgery were randomly assigned to two groups for dural puncture using two Sprotte needles: 27G or 29G. We recorded time to perform puncture, number of re-insertations of the needle, number of times the technique was abandoned and anesthetic efficacy. On the second and seventh days, the patients were interviewed by telephone to check for the presence and severity of post-dural puncture headache or lumbar backache.


RESULTS
The technical difficulty was greater with the Sprotte 29G needle, as shown by significant differences in time taken to perform the puncture and the number of re-insertions (p < 0.05). Anesthetic quality was the same in both groups and the percentage of failures was 0.5% for both. Five percent of patients in the 27G group and 3% in the 29G group experienced slight or moderate headache on the second day. No cases of severe cephalea were reported. Lumbar backache was reported on the second day by 26% and 18.5% of the patients in the 27G and 29G groups, respectively, but the rates decreased to 4.5% and 0.5% on the seventh day. The differences were significant, favoring the 29G needle.


CONCLUSIONS
The use of 29G pencil-point needles can be recommended to reduce the incidence of headache and lumbar backache in the postoperative period, in spite of the greater technical difficulty involved, given that quality of anesthesia is maintained.
Morros-Viñoles
C
C
Servicio de Anestesiología, Reanimación y Terapia del Dolor, Centro hospitalario MIDAT MUTUA (Mutua Metalúrgica de Accidentes de Trabajo), Barcelona. 18450cmv@comb.es
Pérez-Cuenca
M D
MD
Cedó-Lluís
E
E
Colls
C
C
Bueno
J
J
Cedó-Vallobá
F
F
D000328:Adult; D000775:Anesthesia, Spinal / Q000009:adverse effects* / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006261:Headache / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D017116:Low Back Pain / Q000453:epidemiology / Q000209:etiology; D008297:Male; D009339:Needles / Q000009:adverse effects*; D013346:Subarachnoid Space