Ahn W-S, Bahk J-H, Lim Y-J, Kim Y-C
Department of Anaesthesiology and Clinical Research Institute, University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Anaesthesia. 2002 Oct;57(10):1007-11. doi: 10.1046/j.1365-2044.2002.02657.x.
This study was performed to determine how the use of an introducer affects the extent to which a needle deflects during a spinal or combined spinal-epidural injection. A polystyrene block was used to simulate the paraspinal area of the back. A line was drawn perpendicular to the edge of the block to use as a guide and to measure the deflection. The use of an introducer needle decreased the deflection in all the bevelled needles (p < 0.001). Depending on the direction of both the bevels, the deflection decreased as the introducer bevel was changed from the same direction, to right-angles to bevel direction and then to a direction opposite to that of the spinal needle (p < 0.05). Deflection was decreased when a thick introducer was used (p < 0.001). The use of an introducer increased the deflection of the pencil-point needle only in the deflection direction of the introducer (p < 0.001). The 18-gauge Tuohy needle with a "backhole" deflected more than the corresponding needle without a backhole (p < 0.001), and the spinal needle inserted through the Tuohy needle with a backhole deflected more (p = 0.002). Besides the tip type and gauge, the deflection of a spinal needle depends upon the use of introducer, its gauge and bevel direction. The deflection of a Tuohy needle depends upon its design, gauge and the presence of a backhole.
本研究旨在确定在脊髓或腰麻-硬膜外联合穿刺注射过程中，使用引导针如何影响穿刺针的偏斜程度。使用聚苯乙烯块模拟背部椎旁区域。在该块的边缘画一条垂线作为引导线并测量偏斜度。使用引导针可减小所有斜面穿刺针的偏斜度（p<0.001）。根据两个斜面的方向，随着引导针斜面从相同方向、变为与穿刺针斜面成直角、再变为与穿刺针斜面相反方向改变，偏斜度减小（p<0.05）。使用粗引导针时偏斜度减小（p<0.001）。使用引导针仅在引导针的偏斜方向上增加了笔尖式穿刺针的偏斜度（p<0.001）。带有“侧孔”的18号Tuohy针比相应的无侧孔针偏斜度更大（p<0.001），并且通过带有侧孔的Tuohy针插入的脊髓穿刺针偏斜度更大（p = 0.002）。除了针尖类型和规格外，脊髓穿刺针的偏斜度还取决于引导针的使用、其规格和斜面方向。Tuohy针的偏斜度取决于其设计、规格和侧孔的有无。
