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Do spinal needle characteristics affect clinical success? An evaluation of buckling behavior.
Abstract Number: F2A-6
Abstract Type: Original Research
Introduction: Although spinal needles are used frequently in the everyday practice of an anesthesiologist performing neuraxial procedures for analgesia or anesthesia, the relative contribution or importance of needle brand, gauge, or tissue depth are not routinely known. Patients at risk for post-dural puncture headache or difficult placement of spinal anesthesia may benefit from different needle choices. Previous work developed a successful testing model to measure the buckling forces of spinal needles (1). The goal of the study was to quantify the buckling force and displacement behavior of commercially available spinal needles at different depths.
Methods: Ten 124-127mm spinal needles of four gauges (22, 24, 25, 27) from four brands were inserted into a 50mm or 70mm depth ballistic gel using a MTS actuator to induce buckling. The critical buckling load and needle buckling energy were measured with a 500N load cell. Needle buckling direction and angle were also calculated using sensors and two cameras. The length of the deformed needle region was measured with calipers.
Results: Using analysis of variance with p<0.05 as significant, we found significant differences in the critical buckling load and buckling energy between spinal needle gauges at both the 50mm and 70 mm depths within brands at different needle gauges, and between brands of the same needle gauge (see Table 1). Significant differences in the deformed needle region length and deformed needle angle were seen as the difference in needle gauge increased (i.e. 22G vs 25G) regardless of brand.
Conclusions: Spinal needle brand and gauge were shown to significantly impact the buckling force and displacement behavior of the spinal needles. The larger the needle, the greater the force needed to cause buckling. This information may assist providers in choosing optimal spinal needles for the general patient population or for specific patient populations in which spinal placement may be difficult. Future studies may evaluate the clinical impact of spinal needle stiffness and degree of buckling on successful spinal placement.
1. Booth JL, et al. Prerequisite to a Smart Spinal Needle: Development of a Pilot Testing Model to Study Spinal Needle Stiffness and Buckling Forces. SOAP abstract 2017.