極細（２７Ｇ）Ｗｈｉｔａｃｒｅ脊椎麻酔針にて著減した腰麻後の頭痛　１，２８５例の経験と他細径針との比較

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タイトル別名
  • 27-Gauge Whitacre Spinal Needle for Proctological Anesthesia: Decreased Incidence of Post dural Puncture Headache.
  • Decreased Incidence of Post dural Puncture Headache
  • 1,285例の経験と他細径針との比較

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説明

Although spinal anesthesia is useful for proctological procedures, postdural puncture headache (PDPH) can be a serious problem. This paper describes how a 27-gauge Whitacre spinal needle may effectively reduce the postdural puncture headache. Development of headache following saddle block spinal anesthesia using 27-gauge Whitacre, 29-, 27-, or 25-gauge Quincke spinal needles in 2024 hemorrhoid surgery cases were studied. The incidence of PDPH in the 4 groups was 0.7 %, 2.0 %, 3.7 %, and 10 % respectively. The results of this study especially show 27-gauge Whitacre needle effectively reduces the incidence of PDPH compared with 27- and 25-gauge Quincke needles. Fine Spinal needles like 27- or 29-gauge needles require a 22-gauge introducer to ease penetration during the procedure. But in some cases, the 29-gauge extremely fine spinal needle cannot successfully achieve dural puncutre because their needle shaft is easily deflected or bent. A 27-gauge Whitacre needle did not require such delicate handling, and kept the incidence of headache low. It was concluded that a 27-gauge Whitacre needle remarkably reduces PDPH without sacrificing successful dural puncture.

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