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Randomized Controlled Trial
. 2020 Jan 30;20(1):32.
doi: 10.1186/s12871-020-0954-9.

Prospective randomized comparison of cerebrospinal fluid aspiration and conventional popping methods using 27-gauge spinal needles in patients undergoing spinal anaesthesia

J U Han  1 , B G Kim  1 , C Yang  1 , W H Choi  1 , J Jeong  1 , K J Lee  1 , H Kim  2
Affiliations
Randomized Controlled Trial

Prospective randomized comparison of cerebrospinal fluid aspiration and conventional popping methods using 27-gauge spinal needles in patients undergoing spinal anaesthesia

J U Han et al. BMC Anesthesiol. .

Abstract

Background: Performing spinal anaesthesia using the conventional popping method with a 27-gauge (27G) spinal needle is technically difficult. In this study, we compared the aspiration and conventional popping method for spinal anaesthesia using 27G Quincke-type needles.

Methods: This prospective, randomized study enrolled 90 patients, aged 19 to 65 years, with American Society of Anesthesiologists physical status I-III, who were undergoing spinal anaesthesia. Patients were randomly assigned to one of two groups using a computer-generated random number table: patients receiving spinal anaesthesia using the aspiration method, in which the needle is advanced with continuous aspiration, or the conventional popping method. The primary outcome measure was the success rate of the first attempt to perform dural puncture. Number of attempts and passages, withdrawal cases, successful attempt time, total procedure time, and actual depth of dural puncture were recorded.

Results: Eighty-eight patients were included in the study. In the aspiration group, the success rate of first attempt for dural puncture was 93.3%, compared with 72.1% in the popping group (P = 0.019). Success involving needle withdrawal was recorded in 4 (8.9%) patients in the aspiration group and 13 (30.2%) in the popping group (P = 0.024). In the popping group, the number of attempts was significantly higher (P = 0.044), and total procedure time was significantly longer (P = 0.023). Actual depths of dural puncture were deeper in the popping group than in the aspiration group (P = 0.019).

Conclusions: The aspiration method using a 27G Quincke-type needle offers clinical benefits for dural puncture compared with the conventional popping method for spinal anaesthesia.

Trial registration: Clinical research information service number: KCT0002815, registered 21/Apr/2018. Retrospectively registered.

Keywords: Aspiration; Cerebrospinal fluid; Lumbar puncture; Spinal anaesthesia.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Enrollment and allocation of patients in the study
Fig. 2
Fig. 2
Number of attempts to achieve successful dural puncture in both groups. *Statistically significant (P ≤ 0.05)
Fig. 3
Fig. 3
Withdrawal cases where cerebrospinal fluid was identified while withdrawing the needle in both groups. *Statistically significant (P ≤ 0.05)
Fig. 4
Fig. 4
Actual depths of dural puncture in both groups. *Statistically significant (P ≤ 0.05)
See this image and copyright information in PMC

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