Evaluation of a spinal needle locking device for use with the combined spinal epidural technique

Success of the 'needle-through-needle' technique for combined spinal epidur al analgesia requires the immobilisation of the spinal needle during intrat hecal injection. A device that achieves this was evaluated in 200 labouring women, randomly allocated to receive a combined spinal epidural using the CSEcure(R) (SIMS Portex, UK) locking needle or a conventional, non-locking technique. Data collection included the incidence of dural click as the spi nal needle penetrated the dura mater, presence of cerebrospinal fluid in th e spinal needle hub and the number of technical failures with the spinal co mponent. Successful dural punctures with the spinal needle were similar for locking and non-locking needles (99.0 vs. 98.0%; p = 0.55), despite a smal l but significant reduction in dural click with the locking needle compared with the non-locking technique (97.0 vs. 84.7%; p < 0.01). Although not st atistically significant, there was a higher number of technical failures, m ainly due to spinal needle movement, in the non-locking group (9.1 vs. 3.1% ; p = 0.08). The locking needle device may be a useful alternative to conve ntional methods for combined spinal epidural analgesia.