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Post-dural puncture related complications after diagnostic lumbar puncture, myelography and spinal anaesthesia
H Flaatten1, J Kråkenes, C Vedeler
1Department of Anaesthesia and Intensive care, Haukeland University Hospital, Bergen, Norway.
Objectives:
This study was conducted to investigate complications after dural puncture.
Material And Methods:
A 15 months' prospective observation study of routine clinical practice with dural puncture at a university hospital was conducted. Quincke spinal needles 0.90 to 1.0 mm O.D. (20-19 g) were used for diagnostic lumbar puncture, 0.70 mm O.D. (22 g) for myelography and 0.40 to 0.50 mm O.D. (27-25 g) for spinal anaesthesia. A questionnaire about post-puncture discomfort was given to the patients, to be returned after 1 week.
Results:
Of 679 questionnaires 537 (79.1%) were returned. Discomfort was experienced by 53.8% of the patients, most often after diagnostic lumbar puncture and myelography. The difference in incidence of headache after diagnostic lumbar puncture and myelography compared with spinal anaesthesia were 27.9% (95% CI: 18.6 to 37.2) and 18.3% (95% CI: 9.1 to 27.5).
Conclusion:
Small diameter and atraumatic spinal needles will reduce patients' discomfort after dural puncture.