Lyons G, Macdonald R, Mikl B
St James' University Hospital, Leeds.
Anaesthesia. 1992 Mar;47(3):199-201. doi: 10.1111/j.1365-2044.1992.tb02117.x.
An evaluation of a 30 gauge spinal needle in a combined epidural/spinal anaesthetic technique for Caesarean section revealed a 25% failure rate of the spinal element. In this unit, no more than 4% of spinal anaesthetics might be expected to fail. One of the reasons for the higher failure rate was that, when using the Tuohy needle as an introducer, the dura was not identified. This prompted us to compare the 'through-the-Tuohy' or needle within needle approach for combined epidural/spinal anaesthesia, with a technique that involved siting the epidural and spinal sequentially in separate spaces. One hundred women requiring elective Caesarean section under spinal anaesthesia were randomised into single or double space groups. The technique failed in 16% of through-the-needle cases, and in 4% of sequential sitings. Combined spinal/epidural anaesthesia for Caesarean section is more successful if each procedure is performed using separate spaces.
一项针对剖宫产联合硬膜外/脊髓麻醉技术中使用25G脊髓穿刺针的评估显示，脊髓穿刺部分的失败率为25%。在本单位，脊髓麻醉的预期失败率不超过4%。失败率较高的原因之一是，在使用Tuohy针作为引导针时，未识别出硬脊膜。这促使我们将联合硬膜外/脊髓麻醉的“通过Tuohy针”或针内针方法，与在不同间隙依次进行硬膜外和脊髓穿刺的技术进行比较。100名需要在脊髓麻醉下进行择期剖宫产的女性被随机分为单间隙组或双间隙组。针内针方法的失败率为16%，依次穿刺的失败率为4%。剖宫产联合脊髓/硬膜外麻醉如果每个步骤在不同间隙进行会更成功。
