[An atraumatic needle for continuous epidural and plexus anesthesia]

The needle type introduced by Edward Tuphy for continuous spinal anaesthesia in 1944 is still used as the standard instrument for epidural anaesthesia up to the present day. Puncture of the dura and severance of the epidural catheter are the typical, though fare, complications of this procedure, giving rise to most of the actions brought for damage suffered during obstetric anaesthesia. The cerebral spinal fluid loss caused by thick needles can have serious consequences, including subdural and intracranial haematoma, cranial nerve pareses, labyrinthine hearing impairments and pneumocephalus. Special Sprotte needle for catheter introduction. In spinal anaesthesia and lumbar puncture the Sprotte needle has proven a very suitable instrument for the CSF loss syndrome and, to a large degree, post-spinal headaches. To adapt the atraumatic properties of this needle point for epidural anaesthesia the needle has been equipped with a plastic ramp to direct catheter insertion, and the opening geometry has been slightly modified for epidural application (see Fig. 1). The lateral catheter channel projects into the base of the needle point, which is thus shortened, and the edges of the needle opening are rounded so that the catheters cannot be severed. This needle bears the type designated "Special Sprotte needle" (EP no. 271715, USP no. 4842585). Needle diameter and application fields. The 1.1-mm (19.5 G) needle with 23-G catheter was introduced for epidural anaesthesia and continuous plexus anaesthesia at the Würzburg University Hospital and has proven itself in routine clinical practice. A 20-G version is being tested with a 25-G catheter for continuous spinal anaesthesia at several centers in USA, because finer spinal catheters are not permitted there by the FDA. For continuous spinal anaesthesia this needle has been available without the modified opening geometry since 1989 in sizes 22 G and 24 G and is wide by used in Europe. CSE technique with special and standard Sprotte needles. Spinal analgesia or anaesthesia) can be performed with the special needle and 123-mm-long 27 G or 29 G standard Sprotte needles before placement of the peridural catheter.