Local Anesthetic and Spinal Needles

Local Anesthetic Needles

• Local anesthetic needles deliver anesthetic to specific areas, numbing the target without affecting consciousness.

Spinal Needles

• Spinal needles are crucial tools for spinal anesthesia.
• They exist in various types, each tailored for specific purposes and patient needs.

Spinal Needle Types Based on Tip

• Cutting needles (Quincke): Easier to insert but cause more tissue damage.
• Non-cutting needles (Whitacre, Sprotte): More challenging to insert, but result in less tissue damage.
• Risk of post-dural puncture headache (PDPH) is higher with cutting needles.

Quincke Needle

• Description: Features a cutting bevel tip.
• Advantages: Easier to insert.
• Disadvantages: Higher risk of PDPH due to the larger hole created.

Whitacre Needle

• Description: Atraumatic, pencil-point needle with a side hole.
• Advantages: Lower risk of PDPH, less tissue damage.
• Disadvantages: Slightly more challenging to insert.

Sprotte Needle

• Description: Similar to Whitacre but with a longer side hole.
• Advantages: Lower risk of PDPH, better cerebrospinal fluid (CSF) flow.
• Disadvantages: More difficult to handle.

Spinal Needle Sizes and Color Coding

• Spinal needles are sized by gauge (G).
• Larger gauge numbers correspond to thinner needles.
• Thinner needles are less likely to cause post-spinal headache, but need precision.
• Color-coding simplifies gauge identification.

Spinal Needle Lengths

• Short needles: Suitable for pediatric patients.
• Standard needles (around 90 mm): Suitable for most adults.
• Long needles: Used for obese patients or deeper reach.

Epidural Anesthesia Needle

• Epidural needles deliver anesthetic into the epidural space, outside the dura mater, containing cerebrospinal fluid (CSF).

• Size and Gauge: Usually larger than spinal needles (16G-18G).

• Length: Typically 8-9 cm to reach the epidural space.

• Tip Design: Commonly Tuohy needles, with a curved, blunt tip to avoid dural puncture.

• Catheter: Often used to insert a catheter for continuous or intermittent anesthetic administration.

Combined Spinal-Epidural (CSE) Needles

• Needle-through-needle (NTN) technique is a common method.

Standard Local Anesthesia Needles

• Gauge: Typically 25G to 30G.
• Length: Varies from short (20 mm) to long (32 mm).
• Use: Common in dental procedures, minor surgeries, and regional blocks.
• Design: Includes bevel, shaft, hub, syringe adapter, and cartridge penetration end.

Ultrasound-Guided Needles

• Gauge: Often 22G to 25G.
• Length: Longer needles (up to 100 mm) for deeper tissue access.
• Use: Precise anesthetic placement, nerve blocks.
• Design: Echogenic markings or coatings for visibility under ultrasound.