Deformed spinal needle causing PDPH and dry tap due to blood clot
- PMID: 22915865
- PMCID: PMC3417944
- DOI: 10.2147/lra.s11124
Deformed spinal needle causing PDPH and dry tap due to blood clot
Abstract
Postdural puncture headache (PDPH) is a significant complication of spinal anesthesia. There is considerable variability in the incidence of PDPH, which is affected by a number of factors including age, gender, pregnancy, and needle type and size. We present a case where a patient had PDPH after a spinal block with a deformed spinal needle due to calcified interspinous ligaments. We suggest, in the elderly patient with possible ligament calcification, an introducer needle should be used to achieve the spinal block and if there are multiple attempts then the needle should be checked for damage in between. Also, change in the resistance from previous tries or a gritting sensation during needle insertion should be taken seriously and the needle checked before further attempts are made.
Keywords: PDPH; damaged spinal needle tip; elderly.
References
-
- Turnbull DK, Shepherd DB. Postdural puncture headache: pathogenesis, prevention and treatment. Br J Anaesth. 2003;91:718–729. - PubMed
-
- Hafer J, Rupp D, Wollbruck M, Engel J, Hempelmann G. The effect of needle type and immobilization on postspinal headache. Anaesthetist. 1997;46:860–866. - PubMed
-
- Jokinen MJ, Pitkanen MT, Lehtonen E, Rosen Berg PH. Deformed spinal needle tips and associated dural perforations examined by scanning electron microscopy. Acta Anaesthesiol Scand. 1996;40:687–690. - PubMed
-
- Iannuzzi M, Voila G, Cerulli A, Chiefari M, Iannuzzi E. Deformation of the 27-gauge, 3.5 inch Whitacre spinal needle: macroscopic and microscopic findings. Minerva Anestesiol. 2007;73:525–527. - PubMed
-
- Lipov EG, Sosis MB, McCarthy RJ, Ivankovich AD. Does the design of the Sprotte spinal needle reduce the force needed to deform the tip? J Clin Anesth. 1994;6:411–413. - PubMed
Publication types
LinkOut - more resources
Full Text Sources
Miscellaneous
