scholarly journals Depth of spinal needle insertion and its associated factors among patients who underwent surgery under spinal anesthesia

2021 ◽  
pp. 100143
Author(s):  
Nesra Fati ◽  
Girmay Fitiwi ◽  
Abebe Aynalem ◽  
Abebe Muche
2020 ◽  
Vol 7 (7) ◽  
pp. 554-559
Author(s):  
Mehmet Tercan ◽  
Tuğba Bingöl Tanrıverdi ◽  
Gülçin Patmano ◽  
Ahmet Atlas ◽  
Ahmet Kaya ◽  
...  

Objective: Post-dural puncture headache (PDPH) is one of the most important complications after spinal anesthesia. This study aimed to investigate the effect of the sagittal or transverse application of 25-gauge Quincke spinal needle on PDPH development in patients undergoing cesarean section. Material and Methods: A total of 295 patients with a planned cesarean section between the ages of 18-40 years with an American Society of Anesthesiologists score of 1 or 2 were included in the study. For the spinal intervention, 25-gauge Quincke spinal needle was used in all patients. Patients were included in one of two groups according to the spinal needle cutting direction of the dura mater fibers as sagittal (parallel to dura mater fibers, Group S; n=145) or transverse group (perpendicular to dura mater fibers, Group T; n=150). Results: PDPH developed in 27 (9.2%) patients. Patients in Group T had significant higher ratio of PDPH compared to patients in Group S (16% vs. 2.1%, p<0.001). Additionally, patients with PDPH had a significantly higher frequency of ≥2 spinal puncture attempts compared to patients without PDPH (22.2% vs. 4.5%, p=0.003). Multivariate logistic regression analysis demonstrated that transverse needle direction (OR: 11.40, 95% CI: 2.73-34.71; p<0.001) and ≥2 spinal puncture attempts (OR: 9.73, 95% CI: 3.13-41.55; p<0.001) and were independent predictors for PDPH development. Conclusion: Transverse insertion of the 25-gauge Quincke needle into spinal cord fibers and repeated interventions are independently associated with the development of PDPH in cesarean section patients undergoing spinal anesthesia


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Samuel Debas Bayable ◽  
Seid Adem Ahmed ◽  
Girmay Fitiwi Lema ◽  
Debas Yaregal Melesse

Background. Spinal anesthesia is the most common anesthetic technique for cesarean delivery. Patient satisfaction is a subjective and complicated concept, involving physical, emotional, psychological, social, and cultural factors. Regular evaluation of maternal satisfaction related to anesthesia service is an important parameter to the required changes and expansion of high-quality care services. We aimed to assess maternal satisfaction and associated factors among parturients who underwent cesarean delivery under spinal anesthesia. Methods. Institutional-based cross-sectional study was conducted from February to May 2019. A total of 383 parturients were enrolled to assess maternal satisfaction using a 5-point Likert scale. Both bivariable and multivariable logistic regression analyses were done. Variables of p value ≤0.2 in the bivariable analysis were a candidate for multivariable logistic regression. A p value <0.05 was considered as significantly associated with maternal satisfaction at 95% CI. Results. This study revealed that 315 (82.3%) of the parturients were satisfied. Single spinal prick attempts (AOR = 2.08, 95% CI = 1.05–4.11), successful spinal block (AOR = 7.17, 95% CI = 3.33–15.43), less incidence of postdural puncture headache (AOR = 2.36, 95% CI = 1.33–4.20), and prophylactic antiemetic use (AOR = 0.35, 95% CI = 0.19–0.66) were positively associated with maternal satisfaction. Conclusions. The overall maternal satisfaction receiving spinal anesthesia was considerably low. Single spinal prink attempts, successful spinal block, and less incidence of postural puncture headache can increase maternal satisfaction. Therefore, effective perioperative management, skillful techniques, and using the small-gauge Quincke spinal needle (25–27 gauge) may increase the maternal satisfaction and quality of spinal anesthesia management.


2003 ◽  
Vol 12 (4) ◽  
pp. 310 ◽  
Author(s):  
Neeraj Kumar ◽  
Tripiti Sinha ◽  
V.K. Grover

2021 ◽  
Vol 10 (24) ◽  
pp. 1845-1847
Author(s):  
Sanjot Ninave ◽  
Aditya Rameshbabu Devalla

Fine gauze spinal needles are known to decrease the incidence of postdural puncture headache (PDPH) in patients undergoing spinal anaesthesia. We present a rare case of syncopal attack in a patient posted for caesarean section. A patient undergoing elective surgery with inadequate anxiolysis can have a rare chance of a syncopal attack. Hence, high level of suspicion and management of a vasovagal attack is vital. The most common mechanism of syncope is reflex mediated, which can be ‘neurally’ or ‘vasovagally’, and it characteristically develops in the sitting or upright position but may occur in supine position also.1,2 It is characterized by a rapid onset, brief duration, and with a spontaneous recovery. Anxious and apprehensive patients prior to any surgical or anaesthetic procedure can lead to a vasovagal syncope, especially in young females.3 Medline search did not reveal any case report regarding the vasovagal syncope just after spinal needle insertion in young females undergoing spinal anaesthesia. Spinal anaesthesia is the most common anaesthesia performed for lower segment caesarean section (LSCS). A case of syncopal attack with sequence of events, during the insertion of a 25 G Whitacre spinal needle, in a parturient posted for emergency lower segment caesarean section, is discussed here.


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