///2010 Abstract Details
2010 Abstract Details2018-05-01T17:52:49+00:00

CSE for Cesarean Section: Gertie Marx versus PENCAN Spinal Needles

Abstract Number: 75
Abstract Type: Original Research

Maria Negron MD1 ; Shaul Cohen MD2; Shruti Shah MD3; Geza Kiss MD4; Dora Zuker MD5; Christine W. Hunter MD6

PENCAN spinal S/A & ESPOCAN epidural needles are used routinely for CSA for C/S. However, we frequently encountered difficulty piercing the dura forcing us to switch to epi block. We compared Gertie Marx (GM) with PENCAN (P) S/A needle to determine which one is preferred to be applied for our pts.

124 ASA I-II pts were included. The epil space was located with ESPOCAN 18 gauge epi "Braun" needle (B. Braun Medical Inc.) at L4-5 or L3-4 with LOR to air tech in midlin. Pts were then randomized to: Gr I: 59 had a 25 g P S/A needle placed in the S/A space. Gr II: 65 had a 26 g GM needle (IMD Inc. USA) placed in S/A space. Patients received S/A10 mg isobaric bupiv with 25mcg fentanyl and 100 mcg epineph. When the dura could not be pierced by S/A needle the epi needle was rotated 45 degree at a time for further attempts. If still unsuccessful, S/A needle removed and epi block was applied. All pts had a 19g Arrow FlexTip plus (Arrow international Inc.) cath 4 cm in the epi space. An investigator recorded pts height, weight, parity, patients position, the distance of epidural space from the skin, techl problems, paresthesia and pain from S/A needle, time to incision, diff with cath insertion, PDPH, transient radicular irritability, duration of op. and overall satisfy.. Values are meanSD, p<0.05 signif.

RESULTS: Groups did not differ with demographics, the distance of epi space, duration of surgery, previous neuraxial bl, the need to rotate or reinsert the epi needle, the efficacy of the block, side effects, difficulty with cath insertion, the sensory level overall satisfy., or the APGAR score. Time to incision was 33 8 and 24 6 min for Group I and II respectively (p= 0.0001). Time to T6 was 6 4 and 2.6 2 min for Group I & II respectively (p= 0.0001

PENCAN n=59 Gertie Marx n=65 p Value

N (%) N(%)

Lateral Position 55 ((98) 48 (80) 0.002

Spinal needle 34 (58) 19 (29) 0.001

Problem

Leg jerk upon 24 (41) 10 (16) 0.001

needle insert

Paresth. Upon 3 3.8 1.4 3 0.02

needle insert

Pierced dura+ 36 (61) 56 (88 0.001

successful block

Sedation(0-10) 0.1 0.5 3.3 3.9 0.0001

Overall Satisf. 9.3 1.1 9.6 1.0 0.09

(0-10)

CONCLUSION: Application of P S/A needle when compared to GM needle for C/S had less success piercing the dura, caused more paresthesia and pain during insertion, prolonged time to incision and required switch to epidural block more often.

SOAP 2010