Abstract

Background and objectives: A technique for spinal anesthesia in which a subarachnoid tap is done with a needle whose cutting tip is 29G is described. The method was used in 1,254 young patients. The objective of this retrospective study was to evaluate the success, difficulties, and incidence of complications using a 29G Quincke-type needle without an introducer. 

Methods: Various types of surgery were performed with isobaric and hyperbaric local anesthetics in 1,254 non-obstetric young patients using a 29G Quincke needle. Difficulty in localizing the space and time taken to administer spinal anesthesia were noted. Postoperatively, the incidence and severity of headache, backache, and any auditory symptoms were recorded. Patient satisfaction was assessed by telephone in the postoperative period after hospital discharge. 

Results: Patients of both sexes, under 50 years of age, from various surgical specialties, underwent spinal anesthesia with a 29G Quincke needle without an introducer, punctured between L2 and L4, inserted via the median (4%) and paramedian approaches (96%), with punctured in the lateral decubitus position (96%) and median (4%). PDPH occurred in only three patients (0.2%) and showed no correlation with the number of attempts. The puncture position was lateral decubitus and seated; similarly, the paramedian and median insertion positions were not studied for correlation with PDPH. There were 40 (3.1%) failures, justified by surgical time. 

Conclusion: The appearance of PDPH did not disappear with the 29G needle, however all three were mild and responded to clinical treatment, without the need for a blood patch. No neurological complications occurred. All patients evaluated after hospital discharge were very satisfied with the technique.

Keywords

needle, spinal, regional, spinal, headache, backache, needle bending