Lower incidence of postdural puncture headache using whitacre spinal needles after spinal anesthesia: A meta‐analysis

Zhang, Di; Chen, Lingxiao; Chen, Xingyu; Wang, Xiaobo; Li, Yulin; Ning, Guangzhi; Feng, Shiqing

doi:10.1111/head.12745

Cited by 26 publications

(45 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We believed that the great performance of pencil-point needle derive from its capability of reducing the damage of dural fibers and the loss of CSF and promoting healing. [19,35,46] This was in line with the guideline of American Academy of Neurology in 2013 [47] which recommended the use of pencil-point needles because of lower rates of headache following lumbar puncture in randomized trials.…”

Section: Discussionsupporting

confidence: 58%

“…Our previous meta-analysis showed Whitacre spinal needle was better than Quincke spinal needle. [19] We had further conjectured that pencil-point spinal needle might be better than cutting spinal needle. Therefore we searched all types of spinal needle to compare the effects.…”

Section: Discussionmentioning

confidence: 99%

“…[9,15] However, extremely thin spinal needles would increase the rate of failure for spinal anesthesia, resulting in multiple dural punctures and high incidence rate of PDPH. [10,16–19] Apart from the spinal needle size, spinal needle shape might be the most important modifiable risk factors of PDPH. And we consider pencil-point spinal needle another effective way to reduce the incidence of PDPH in spinal anesthesia and lumbar puncture.…”

Section: Discussionmentioning

confidence: 99%

“…And multiple dural punctures caused by unsuccessful puncture would increase the rate of PDPH. [10,16–19] And sometimes CSF is too viscous to come through a small needle. [5] …”

Section: Introductionmentioning

confidence: 99%

“…Our previous meta-analysis showed Whitacre spinal needle was better than Quincke spinal needle. [19] However, it was also limited as only 9 RCTs were included, and only 2 kinds of spinal needles, Whitacre spinal needle and Quincke spinal needle, were compared.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Comparison of cutting and pencil-point spinal needle in spinal anesthesia regarding postdural puncture headache

et al. 2017

Self Cite

View full text Add to dashboard Cite

Background:Postdural puncture headache (PDPH), mainly resulting from the loss of cerebral spinal fluid (CSF), is a well-known iatrogenic complication of spinal anesthesia and diagnostic lumbar puncture. Spinal needles have been modified to minimize complications. Modifiable risk factors of PDPH mainly included needle size and needle shape. However, whether the incidence of PDPH is significantly different between cutting-point and pencil-point needles was controversial. Then we did a meta-analysis to assess the incidence of PDPH of cutting spinal needle and pencil-point spinal needle.Methods:We included all randomly designed trials, assessing the clinical outcomes in patients given elective spinal anesthesia or diagnostic lumbar puncture with either cutting or pencil-point spinal needle as eligible studies. All selected studies and the risk of bias of them were assessed by 2 investigators. Clinical outcomes including success rates, frequency of PDPH, reported severe PDPH, and the use of epidural blood patch (EBP) were recorded as primary results. Results were evaluated using risk ratio (RR) with 95% confidence interval (CI) for dichotomous variables. Rev Man software (version 5.3) was used to analyze all appropriate data.Results:Twenty-five randomized controlled trials (RCTs) were included in our study. The analysis result revealed that pencil-point spinal needle would result in lower rate of PDPH (RR 2.50; 95% CI [1.96, 3.19]; P < 0.00001) and severe PDPH (RR 3.27; 95% CI [2.15, 4.96]; P < 0.00001). Furthermore, EBP was less used in pencil-point spine needle group (RR 3.69; 95% CI [1.96, 6.95]; P < 0.0001).Conclusions:Current evidences suggest that pencil-point spinal needle was significantly superior compared with cutting spinal needle regarding the frequency of PDPH, PDPH severity, and the use of EBP. In view of this, we recommend the use of pencil-point spinal needle in spinal anesthesia and lumbar puncture.

show abstract

Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…And multiple dural punctures caused by unsuccessful puncture would increase the rate of PDPH. [10,16–19] And sometimes CSF is too viscous to come through a small needle. [5] …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations