[Evaluation of 26G pencil point spinal needle in combined epidural-spinal anesthesia]

Twenty six gauge pencil point spinal needles and an adaptor for the fixation of the spinal needle were developed for combined epidural/spinal anesthesia on an experimental basis and applied on 110 patients. The length of the spinal needles was either 11.7 cm or 13 cm. Fifty out of 110 patients were punctured with the 11.7 cm needle and then were divided into 2 groups. The difference in length of the spinal and epidural needles was 8 mm in group 1 and 15 mm in group 2. In 80% of the patients in group 1 and in 95% of the patients in group 2, the subarachnoidal space was reached on the first puncture. These results indicate that the subarachnoidal space can be more easily punctured when a spinal needle 15 mm longer than the epidural needle is used. On the other hand, when a 13 cm spinal needle was employed, it often did not remain in place during drug injection. This problem could be solved, however, by using an adaptor with which the spinal needle was fixed firmly on the epidural needle at the point of dural puncture. The incidence of the post dural puncture headache was 1.7% (1 out of 60 patients).