Tarkkila P, Huhtala J, Salminen U
Uppsala University Hospital, Sweden.
Anaesthesia. 1994 Aug;49(8):723-5. doi: 10.1111/j.1365-2044.1994.tb04410.x.
The effect of different size (25-, 27- and 29-gauge) Quincke-type spinal needles on the incidence of insertion difficulties and failure rates was investigated in a randomised, prospective study with 300 patients. The needle size was randomised but the insertion procedure was standardised. The time to achieve dural puncture was significantly longer with the 29-gauge spinal needle compared with the larger bore needles and was due to the greater flexibility of the thin needle. However, the difference was less than 1 min and cannot be considered clinically significant. There were no significant differences between groups in the number of insertion attempts or failures and the same sensory level of analgesia was reached with all the needle sizes studied. Postoperatively, no postdural puncture headaches occurred in the 29-gauge spinal needle group, whilst in the 25- and 27-gauge needle groups, the postdural puncture headache rates were 7.4% and 2.1% respectively. The incidence of backache was similar in all study groups. We conclude that dural puncture with a 29-gauge spinal needle is clinically as easy as with larger bore needles and its use is indicated in patients who have a high risk of postdural puncture headache.
在一项针对300例患者的随机前瞻性研究中，调查了不同规格（25号、27号和29号）的昆克式脊髓穿刺针对于穿刺困难发生率和失败率的影响。穿刺针的规格是随机分配的，但穿刺操作是标准化的。与较大孔径的穿刺针相比，使用29号脊髓穿刺针时达到硬膜穿刺的时间明显更长，这是由于细针的柔韧性更强。然而，这种差异小于1分钟，在临床上不具有显著意义。各组之间在穿刺尝试次数或失败次数上没有显著差异，并且所有研究的穿刺针规格均达到了相同的感觉镇痛水平。术后，29号脊髓穿刺针组未发生硬膜穿刺后头痛，而在25号和27号穿刺针组中，硬膜穿刺后头痛发生率分别为7.4%和2.1%。所有研究组的背痛发生率相似。我们得出结论，使用29号脊髓穿刺针进行硬膜穿刺在临床上与使用较大孔径的穿刺针一样容易，对于有硬膜穿刺后头痛高风险的患者建议使用。
