[Evaluation of a lockable combined spinal-epidural device for use with needle-through-needle technique].
BACKGROUND
Recently, a new combined spinal-epidural (CSE) device has been introduced which allows the spinal needle to be extended a maximum of 15 mm beyond the Tuohy needle and locked onto the epidural needle after dural puncture. The aim of this study was to compare this lockable CSE device with the conventional CSE device, which allows the spinal needle to be extended 9 mm beyond the Tuohy needle, and to measure the length of the protrusion of the spinal needle beyond the Tuohy needle (top-to-top distance: TTD).


METHODS
We studied sixty patients scheduled to undergo elective gynecological surgery and cesarean section. Patients were divided into three groups: patients in Group I (n = 20) using the conventional CSE device in gynecological surgery; patients in Group II (n = 20) using the lockable CSE device in gynecological surgery; and patients in Group III (n = 20) using the lockable CSE device in cesarean section.


RESULTS
The success rate of spinal anesthesia with needle-through-needle technique was higher with the lockable CSE device (100%) than with the conventional CSE device (75%). The TTD was 7.9 +/- 1.8 (SD) cm in non-pregnant group (Group II) and 8.7 +/- 1.5 cm in pregnant group (Group III). This difference was not statistically significant. In the lockable CSE device groups (Group II and III), 10 patients (25%) had a TTD of 10 mm or more.


CONCLUSIONS
The lockable CSE device improves the success rate of spinal anesthesia in needle-through-needle CSE anesthesia.
Tanaka
Nobuhiko
N
Department of Anesthesia, Amakusa Central General Hospital, Hondo 863-0033.
Ohkubo
Shigeaki
S
Takasaki
Mayumi
M
D000328:Adult; D000767:Anesthesia, Epidural / Q000295:instrumentation*; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal / Q000295:instrumentation*; D002585:Cesarean Section; D017558:Elective Surgical Procedures; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D009339:Needles; D011247:Pregnancy