Spinal anesthesia using 29G pencil point needle: a large single center experience in non-obstetric patients

Abstract

Objectives: Spinal anesthesia is a technique in which a local anesthetic is administered into the subarachnoid space. For this, different caliber and style needles are used, one of them, the pencil point needle, has reported a lower incidence of post-dural puncture headache (PDPH) and adverse events. However, failure rates vary, possible technical difficulty being one of the causes. In this context, the objective of this study was to evaluate the incidence of PDPH, the time in seconds to obtain cerebrospinal fluid (CSF) and the anesthetic success rate with the spinal technique using a 29G pencil point needle, for non-obstetric procedures. Methods: Unique historical cohort (2016-2019) of 812 patients over 18 years old. Among the variables observed there were sociodemographic characteristics, number of lumbar puncture attempts, CSF collection time, patient position for the anesthetic procedure, type of surgery, anesthetic failure, and appearance of PDPH. Stata SE14.0 software was used for the statistical analysis of the information. Results: No cases of PDPH were observed. The average time for obtaining CSF was 86.1 seconds, with the factors associated with a higher time frame being the position in lateral decubitus and age. The anesthetic success rate was 99.2%. Conclusion: The use of the 29G pencil point needle for subarachnoid anesthesia in patients for non-obstetric surgery, in the observed cohort, reported a success rate close to 100%. The time to obtain CSF can be slow compared to the use of larger gauge needles and varies with the position and age of the patient.