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Online ISSN 1827-1596
Iannuzzi M., Viola G., Cerulli A., Chiefari M., Iannuzzi E.
Second Service of Anesthesia; Department of Anesthesiology, Surgery and Emergency Sciences, Second University of Naples, Naples, Italy
Gross deformation of the spinal needle shaft or the tip may occur during spinal needle insertion. During a one-year period, three cases of severe deformation of 27-gauge, 3.5 inch Whitacre spinal needles (B-Braun) occurred during standard spinal anesthesia in otherwise healthy patients. During this one-year period, we collected cut-bevel-point needles when bone impact occurred and compared them to the points of identical unused needles under a microscope. We believe that these microdeformations may be the cause of anatomical damage. We should be aware of even small resistance during spinal needle insertion because of the possibilities of severe deformation and injury of the anatomical structures, or of dramatic in situ breakage of the spinal needle. We should also be vigilant with respect to bone contact of the spinal needle, because needle points are damaged and can cause dural lacerations with subsequent cerebrospinal fluid leakage.