A NEW ATRAUMATIC NEEDLE FOR CONTINUOUS EP IDURAL AND PLEXUS ANESTHESIA

The needle type introduced by Edward Tuohy for continuous spinal anaes thesia in 1944 is still used as the standard instrument for epidural a naesthesia up to the present day. Puncture of the dura and severance o f the epidural catheter are the typical, though rare, complications of this procedure, giving rise to most of the actions brought for damage suffered during obstetic anaesthesia. The cerebral spinal fluid loss caused by thick needles can have serious consequences, including subdu ral and intracranial haematoma, cranial nerve pareses, labyrinthine he aring impairments and pneumocephalus. Special Sprotte needle for cathe ter introduction. In spinal anaesthesia and lumbar puncture the Sprott e needle has proven a very suitable instrument for prevent the CSF los s syndrome and, to a large degree, post-spinal headaches. To adapt the atraumatic properties of this needle point for epidural anaesthesia, the needle has been equipped with a plastic ramp to direct catheter in sertion, and the opening geometry has been slightly modified for epidu ral application (see Fig. 1). The lateral catheter channel projects in to the base of the needle point, which is thus shortened, and the edge s of the needle opening are rounded so that the catheters cannot be se vered. This needle bears the type designated ,,Special Sprotte needle' ' (EP no. 271715, USP no. 4842585). Needle diameter and application fi elds. The 1.1-mm (19.5 G) needle with 23-G catheter was introduced for epidural anaesthesia and continuous plexus anaesthesia at the Wurzbur g University Hospital and has proven itself in routine clinical practi ce. A 20-G version is being tested with a 25-G catheter for continuous spinal anaesthesia at several centers in USA, because finer spinal ca theters are not permitted there by the FDA. For continuous spinal anae sthesia this needle has been available without the modified opening ge ometry since 1989 in sizes 22 G and 24 G and is wide by used in Europe . CSE technique with special and standard Sprotte needles. Spinal anal gesia or anaesthesia (combined spinal-epidural anaesthesia) can be per formed with the special needle and 123-mm-long 27 G or 29 G standard S protte needles before placement of the peridural catheter.