Spinal anaesthesia requires specialised needles and introducers in addition to the general equipment necessary for central nerve blocks (see Figure RA.6) There is an inevitable incidence of post dural puncture headache (PDPH) with spinal anaesthesia ranging from 0.2 to 24% and many designs of needle have been introduced to try and reduce this problem. Currently the lowest incidence of PDPH is associated with very narrow gauge, short bevel needles (26-29 G) and 24 G pencil point, Whitacre tip designs or the more specialised Sprotte designs with a large side opening hole. The narrow gauge and relatively blunt tips of these needles require insertion through a properly designed introducer, which should be closely matched to the type of spinal needle being used to avoid tip damage.
Figure RA.6 Tip design of spinal needles
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