Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2016.07.011
Brazilian Journal of Anesthesiology
Scientific Article

A comparison of three different needles used for spinal anesthesia in terms of squamous epithelial cell transport risk

Comparação de três agulhas diferentes usadas para raquianestesia em relação ao risco de transporte de células epiteliais escamosas

Ünal Kantekin Çiğ; dem; Ş; ahin Sevinç; Bolat Esef; Öztürk Süreyya; Gencer Muzaffer; Demirel Akif

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Abstract

Abstract Background and objectives To investigate the differences in the number of squamous epithelial cells carried to the spinal canal by three different types of spinal needle tip of the same size. Methods Patients were allocated into three groups (Group I, Group II, Group III). Spinal anesthesia was administered to Group I (n = 50) using a 25G Quincke needle, to Group II (n = 50) using a 25G pencil point spinal needle, and to Group III (n = 50) using a non-cutting atraumatic needle with special bending. The first and third drops of cerebral spinal fluid (CSF) samples were taken from each patient and each drop was placed on a slide for cytological examination. Nucleated and non-nucleated squamous epithelial cells on the smear preparations were counted. Results There was statistically significant difference between the groups in respect to the number of squamous epithelial cells in the first drop (p < 0.05). Group III had lower number of squamous epithelial cells in the first drop compared to that of Group I and Group II. Mean while Group I had higher number of squamous epithelial cells in the third drop compared to the other groups. The number of squamous epithelial cells in the first and third drops was statistically similar in each group respectively (p > 0.05 for each group). Conclusions In this study of different needle tips, it was seen that with atraumatic needle with special bending a significantly smaller number of cells were transported when compared to the Quincke tip needles, and with pencil point needles.

Keywords

Spinal anesthesia, Cerebrospinal fluid, Spinal needles, Epithelial cells

Resumo

Resumo Justificativa e objetivo Investigar as diferenças no número de células epiteliais escamosas transportadas para o canal medular por três tipos diferentes de pontas de agulhas espinhais do mesmo tamanho. Métodos Os pacientes foram alocados em três grupos (Grupo I, Grupo II, Grupo III). Raquianestesia foi administrada aos pacientes do Grupo I (n = 50) com agulha Quincke de 25G, do Grupo II (n = 50) com agulha espinhal ponta de lápis de 25G e do Grupo III (n = 50) com agulha atraumática não cortante de curvatura especial. A primeira e terceira gotas de líquido cefalorraquidiano (LCR) foram colhidas de cada paciente para amostra e cada gota foi colocada em lâmina para exame citológico. As células epiteliais escamosas nucleadas e não nucleadas sobre as lâminas de esfregaço foram contadas. Resultados Houve diferença estatisticamente significativa entre os grupos em relação ao número de células epiteliais escamosas na primeira gota (p < 0,05). O Grupo III apresentou um número menor de células epiteliais escamosas na primeira gota, em comparação com os grupos I e II, enquanto o Grupo I apresentou um número maior de células epiteliais escamosas na terceira gota, em comparação com os outros grupos. Os números de células epiteliais escamosas na primeira e terceira gotas foram estatisticamente semelhantes em cada grupo, respectivamente (p > 0,05, para cada grupo). Conclusões Neste estudo de pontas de agulha diferentes, verificamos que com a agulha atraumática de curvatura especial o número de células transportadas foi significativamente menor, em comparação com as agulhas Quincke e ponta de lápis.

Palavras-chave

Raquianestesia, Líquido cefalorraquidiano, Agulhas espinhais, Células epiteliais

References

Critchley M, Ferguson FR. The cerebrospinal epidermoids (Cholestealoma). Brain. 1928;51:334-84.

Taveira MHC, Carneiro AF, Rassi GG. There is high incidence of skin cells in the first and third drops of cerebrospinal fluid in spinal anesthesia. Rev Bras Anestesiol. 2013;63:193-6.

Potgieter S, Dimin S, Lagae L. Epidermoid tumors associated with lumbar punctures performed in early neonatal life. Dev Med Child Neurol. 1998;40:266-9.

Ziv ET, McComb GJ, Krieger MD, Skaggs DL. Iatrogenic intraspinal epidermoid tumors: two cases and a review of the literature. Spine. 2004;29:E15-8.

McDonal JV, Klump TE. Intraspinal epidermoid tumors caused by lumbar puncture. Arch Neurol. 1986;43:936-9.

Campbell DC, Douglas MJ, Taylor G. Incidence of tissue coring with the 25-Gauge Quincke and Whitacre spinal needles. Reg Anesth. 1996;21:582-5.

Choremis C, Economos D, Papadatos C, Gargoulas A. Intraspinal epidermoid tumours (cholesteatomas) in patients treated for tuberculous meningitis. Lancet. 1956;2:437-9.

Tunalı Y, Kaya G, Tunalı G, Solakoğlu S, Yenice S, Bahar M. Detection of epithelial cell transfer in spinal areas by light microscopy and determining any tissue coring via cell culture during combined spinal-epidural interventions. Reg Anesth Pain Med. 2006;31:539-45.

Manno NJ, Uihlein A, Kernohan JW. Intraspinal epidermoids. J Neurosurg. 1962;19:754-6.

Puolakka R, Andersson LC, Rosenberg PH. Microscopic analysis of three different spinal needle tips after experimental subarachnoid puncture. Reg Anesth Pain Med. 2000;25:163-9.

Sharma B, Gupta S, Jain N, Handoo A, Sood J. Cerebrospinal fluid cytology in patients undergoing combined spinal epidural versus spinal anaesthesia without an introducer. Anaesth Intensive Care. 2011;39:914-8.

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