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IS IT POSSIBLE TO TACTUALLY RECOGNIZE DURAL PUNCTURE RESISTANCE DURING PUNCTURE FOR SPINAL ANESTHESIA?

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ESRA-2018

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Abstract

While performing spinal subarachnoid anaesthesia, puncture of the arachnoid is difficult to confirm directly and is only noticeable through a subjective tactual sensation. This is why the cerebrospinal fluid reflux serves as the main indicator of the correct needle placement. The “pop” sensation is generally recognized among anaesthetists, but is not considered a sufficient indicator of the arachnoid puncture. In this study, we investigated whethe it is possible to tactually recognize dural puncture resistance during puncture for spinal anesthesia with the fingertip of a person. Fifty doctors punctured 7 kinds of spinal needles into simulated dura mater, Resistance feeling felt by each fingertip was evaluated by NRS. Since the average value of the digitized value correlates with the measured puncture resistance, it was found that the fingertip could discriminate the difference in puncture resistance. From the difference in puncture resistance of each needle and the ratio with which it could be recognized correctly, it was found that 80% of the enforcers can discriminate 0.3 N or more. In spinal anaesthesia, higher resistances felt on dural puncture should facilitate more direct and easier understanding of moment when dura mater is punctured. We think that selection of a spinal needle should involve consideration of aspects related to needle resistance. Thus, the procedure should become easier and eventually safer.

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© Copyright 2020 Morressier GmbH.
All rights reserved.