Sonoda H, Takamatsu J, Takahashi S
Department of Anesthesiology, National Kyushu Medical Center Hospital, Fukuoka.
Masui. 1995 Oct;44(10):1410-4.
Twenty six gauge pencil point spinal needles and an adaptor for the fixation of the spinal needle were developed for combined epidural/spinal anesthesia on an experimental basis and applied on 110 patients. The length of the spinal needles was either 11.7 cm or 13 cm. Fifty out of 110 patients were punctured with the 11.7 cm needle and then were divided into 2 groups. The difference in length of the spinal and epidural needles was 8 mm in group 1 and 15 mm in group 2. In 80% of the patients in group 1 and in 95% of the patients in group 2, the subarachnoidal space was reached on the first puncture. These results indicate that the subarachnoidal space can be more easily punctured when a spinal needle 15 mm longer than the epidural needle is used. On the other hand, when a 13 cm spinal needle was employed, it often did not remain in place during drug injection. This problem could be solved, however, by using an adaptor with which the spinal needle was fixed firmly on the epidural needle at the point of dural puncture. The incidence of the post dural puncture headache was 1.7% (1 out of 60 patients).
为进行硬膜外/脊髓联合麻醉，在实验基础上研制了26号铅笔尖式脊髓穿刺针及用于固定脊髓穿刺针的接头，并应用于110例患者。脊髓穿刺针的长度为11.7厘米或13厘米。110例患者中有50例用11.7厘米的穿刺针进行穿刺，然后分为两组。第一组脊髓穿刺针与硬膜外穿刺针的长度差为8毫米，第二组为15毫米。第一组80%的患者和第二组95%的患者在首次穿刺时就进入了蛛网膜下腔。这些结果表明，当使用比硬膜外穿刺针长15毫米的脊髓穿刺针时，更容易穿刺到蛛网膜下腔。另一方面，当使用13厘米的脊髓穿刺针时，在注药过程中它常常不能固定在位。然而，通过使用一种接头可以解决这个问题，利用该接头在硬膜穿刺点将脊髓穿刺针牢固地固定在硬膜外穿刺针上。硬膜穿刺后头痛的发生率为1.7%（60例患者中有1例）。
