ATRAUCAN(R) - A NEW NEEDLE FOR SPINAL-ANESTHESIA

Background and Objectives. Atraucan(R) 26-gauge spinal needles have a tip designed to make a small linear cut (as opposed to a V-shaped cut) in the dura mater. The cut is shorter than the outside diameter of th e needle and is dilated as the needle passes through the dura. The nee dle is used with a 20-gauge introducer. In vitro, it causes less leaka ge of cerebrospinal fluid than Quincke 26-gauge or Sprotte 24-gauge ne edles. This study was designed to test the ease of use and any damage caused to the needle tip during lumbar dural puncture. Methods. This w as a multicenter trial (six centers in five countries) involving 362 p atients undergoing spinal anesthesia. A detailed questionnaire was fil led in for every patient by the anesthesiologist. All the needles were returned to the factory and examined microscopically for damage. Resu lts. Lumbar dural puncture was successful in all but one patient. Spin al anesthesia was satisfactory for the planned surgery in 97%. Microsc opy of the needle tips showed only a minor degree (0.01-0.19 mm) of be nding in 14%, and none of the tips had a ''hook.'' Postdural puncture headache (PDPH) occurred in nine patients (2.5%), all but one of whom (a 15-year-old male) were females under 55 years of age. Conclusions. The Atraucan(R) needle is easy to use and has a high success rate in i dentifying the subarachnoid space. Lumbar dural puncture causes minima l damage to the tip. The incidence of PDPH is low, but a larger compar ative study needs to be performed.