A prospective study was conducted on 380 patients at age of 16 to 65 who were operated at The Anaesthetic and Recuperative Department of Vietnam-Sec Hospital from Jun 2003 to April 2005. The patients were divided randomly into two groups: Group I using the needle anesthesia Whitacre 25G and Group II using the needle anesthesia Quincke 25G. Results: the pulses of both groups before and after anesthesia were different (p>0.05), the arterial pressure 30 minutes after anesthesia of both groups reduced (p>0.05) the rate of respiratory before and after anesthesia of both groups were different, no case with side effect on respiratory which needed intervention. Spinal anesthesia with hyperbaric Marcain 0.5% (dose 0.2mg/kg) at L3-L4 interspaces causes completely anesthesia for lower extremities operations, side effects were negligible
Anesthesia, Spinal Headache

No abstract available.
Anesthesia, Spinal* ; Arachnoid* ; Headache* ; Humans ; Incidental Findings*

No abstract available.
Anesthesia, Spinal* ; Arachnoid* ; Headache* ; Humans ; Incidental Findings*

PURPOSE: Postdural puncture headache is one well-known complications of spinal anesthesia. The development of postdurals puncture headaches is related to needle size, the direction of the needle bevel, the number of dural punctures and the age of the patient. However, the effect of the sitting position after spinal anesthesia (saddle block) on the incidence of postdural puncture headaches is not yet known. This study was performed to compare the incidence rates of headaches between a saddle block group (sitting position group) and a low spinal anesthesia group (supine position group). In addition, this study was performed to identify the predisposing factors influencing postdural puncture headaches (age, sex, seasonal variation, onset of headache, location of headache). METHODS: The authors analyzed 960 anal-surgery patients who were operated on using a saddle block or low spinal anesthesia at Hang Cinic from Jan. 2000 through Dec. 2000. The authors compared the incidence rates of headaches between the saddle block group (480 cases) and the low spinal anesthesia group (480 cases). RESULTS: 1) The incidence of postdural puncture headaches was not significantly different between the two groups (2.5% in the saddle block group, and 2.3% in the low spinal anesthesia group) (P>0.05). 2) The postdural puncture headache incidence rate was higher for younger patients (20~30 years) and for females. (M:F=7:16) (P<0.05). 3) The onest of postdural puncture headaches was at the postoperative 2nd day in 16 cases (70%) and at the postoperative 3rd day in 6 cases (26%). 4) The incidence rate of postdural puncture headache was higher in the summer (5 cases in June, and 3 cases in July, 4 cases in August). 5) The headache were located in the frontal region in 16 cases (70%) and in the occipital region in 3 cases (13%). CONCLUSIONS: There is no significant difference in the incidence rates of postdural puncture headaches between the saddle block group and the low spinal anesthesia group. Postdural puncture headaches had a tendency to occur more frequently in young female patients and during the summer season. In addition, a more intensive study of the use of saddle block anesthesia for ambulatory anal surgery is required.
Anesthesia ; Anesthesia, Spinal* ; Causality ; Female ; Headache ; Humans ; Incidence* ; Needles ; Post-Dural Puncture Headache* ; Punctures ; Seasons

BACKGROUND: Pencil-point needle currently are used for spinal anesthesia because of an alleged lowered incidence of postdural puncture headache. Although the direction of the side hole is one of the important factors that might affect the level and the duration of anesthesia, those data are not readily available. The aim of this study was to assess if the side hole direction of pencil-point needle during hyperbaric tetracaine injection affects the level and the duration of anesthesia. METHODS: We induced spinal anesthesia in 80 young men presenting for elective orthopedic surgery. Patients were allocated randomly with the side hole direction of the 25 gauge pencil-point needle in one of the four directions; cephalad, caudad, left lateral, right lateral. Hyperbaric 0.5% tetracaine 15~17 mg (3 to 3.4 ml) was injected with the speed of 0.75 ml/sec. Maximum sensory block level, time to maximum sensory block level, duration of sensory block (2 segments regression time) were assessed by a blinded observer with the pin-prick test and degree of motor block were measured by Bromage motor scale. Data were analysed using the Kruskal-Wallis test followed by the Mann-Whitney U test and chi-square test as appropriate (SAS v. 6.04). RESULTS: Time to maximum sensory block level was significantly fast in group 'cephalad'. Other values have no statistical differences. Post-spinal headache was observed in one case in group 'caudad'. CONCLUSIONS: Using the pencil-point needle, the time to maximum sensory block level was fast in group cephalad but there were no differences in the maximum sensory block level and the duration of sensory block among the four groups.
Anesthesia ; Anesthesia, Spinal* ; Headache ; Humans ; Incidence ; Male ; Needles* ; Orthopedics ; Post-Dural Puncture Headache ; Tetracaine*

The incidence of postspinal headache is one of the well known complications of spinal anesthesia. The development of postspinal headache is related to age and sex of patients, needle size, needle configuration, pregnancy, direction of needle bevel, number of dural puncture. This study was done to see the effect of various gauge Quincke needles(22, 23, 24, 25, 26gauge) and needle bevel direction on the incidence, severity, onset and location of postspinal headache in the 200 male patients of the third age decade undergoing spinal anesthesia. There were one group consisting of 100 patients who underwent parallel insertion to longitudinal dural fibers and the other group consisting of 100 patients who underwent vertical. Each group consisting of 100 patients had five subgroups with 20 patients in related to each needle gauge. A system of criteria for registering postspinal headache and its severity is proposed. The following results were observed: 1) The incidence of postspinal headache was 10% in one group who underwent parallel insertion to longitudinal dural fibers but 27% in the other group who underwent vertical. 2) The severity of headache was mild level in all the 10 cases with postspinal headache of parallel insertion group but above moderate level in 14 cases of all the 27 cases with postspinal headache of vertical insertion group. 3) The small size of needle had a trend with lower incidence of postspinal headache than the large size . 4) The onset of postspinal headache was within 3 day after spinal anesthesia in the almost patients(92.5%) with postspinal headache. 6) The sites of postspinal headache were 59.5% in frontal, 18.9% in occipital, 16.2% in generalized, 5.4% in parietal region. In conclusion, the method of insertion parallel to longitudinal dural fibers is significantly lower incidence of postspinal headache than that of insertion vertical to longitudinal dural fibers in young males of the third age decade.
Anesthesia, Spinal ; Headache* ; Humans ; Incidence ; Male* ; Needles* ; Pregnancy ; Punctures ; Rabeprazole

The incidence of postspinal headache is one of the well known complications of spinal anesthesia. Several factors such as needle size, bevel direction, multiple dural puncture and previous history of postspinal headache were thought to influence the incidence of postspinal headache. This studies were done to see the effect of needle size (22 and 25 gauge needle) and needle bevel direction (parallel, vertical, oblique insertion to the longitudinal dural fiber) on the incidence, duration, severity and location of spinal headache in the 548 patients underwent spinal anesthesia. The following results wre observed: 1) Neither needle size nor needle bevel direction had effect on the incidence of severity, duration and location of postspinal headache. 2) The ineidence of headache was 8.8% (48 cases), 3) The onset of headache was 1~2 day (67%) and duration of headache was 4~5 day (85%) in postanesthetic day. 4) The severity of headache was mild and moderate in 77% cases. 5) In the half cases, headache was relieved by means of bed rest alone.
Anesthesia, Spinal ; Bed Rest ; Headache* ; Humans ; Incidence ; Needles* ; Punctures

The incidence of postspinal headache is one of the well known complications of spinal anesthesia. The development of postspinal headache is related to age and sex of patients, size and configuration of the needle, pregnancy, direction of needle bevel, number of dural puncture. I studied the effect of configuration and size of the needle (22 gauge 25 gauge Quinke needle and 22 gauge,25 gauge Whitacre needle ) on the incidence, onset, duration and severity of postspinal headache in the 200 males of the third decade after spinal anesthesia. The following results were observed: 1) The incidence of postspinal headache in 22 gauge, 25 gauge Whitacre needle groups(4%. 2%) is lower than that of 22 gauge, 25 gauge Quinke needle groups(10%, 8%). 2) The severity of headache was mild and moderate level in 7 cases, severe level in 2 cases of all the 9 cases with postspinal headache of Quinke needle groups but mild and moderate level in 3cases of all the 3 cases with postspinal headache of Whitacre needle groups. 3) The onset of headache was within 24 hours in 55.6% in Quinke needle groups, 100% in Whitacre needle groups and the duration of headache was within 5 days in 77.8% in Quinke needle groups, 100% in Whitacre needle groups postoperatively. 4) The sites of headache were 55.6% in frontal, 33.3% in occipital region in Quinke needle groups and 66.7% in frontal, 33.3% in occipital region in Whitacre needle groups. In conclusion, the headaches which occur following use of Whitacre needle have been lower in and of less severity than those seen after use of Quinke needle in young males of the third decade.
Anesthesia, Spinal ; Headache* ; Humans ; Incidence ; Male* ; Needles* ; Pregnancy ; Punctures

Spinal anesthesia is a relatively ease and useful technique and provides excellent analge-sia and relaxation for a great number of surgical procedures. It has been used widelr until the introduction of Muscle relaxant to the general anesthesia. However, complications, including hypotension, nausea, postspinal headache, neurologic sequelae, and death have been reported. In addition to those problems, number of failures after administration of spinal anesthetic haute been reported. We collected the 316 cases of spinal anesthesia given between January to May, 1986.the incidence of failure and the int-errelationships between the incidence and technical factors were reuiewed. Variables exam-ined including the patient population, the technical aspects of performing subarachnoid tap and subsequent blockade, and the level 7f training of anesthetist. Total number of patients with administration of anesthesia for 5 monthes was 2075; 316 patients in spinal anesthesia(15.237). We found a 4, l1% incidence of spinal failure, defined as the need to use general anesthesia or frequent administration of anlgesics during the surgical procedures. The technical factors(position of patients, approach method, puncture sites, needle gauge, agents type, and the performer) were insignificantlr contributed to the failure rate, but the amount of local anesthetic was showed statistical significance.
Anesthesia ; Anesthesia, General ; Anesthesia, Spinal* ; Headache ; Humans ; Hypotension ; Incidence* ; Nausea ; Needles ; Punctures ; Relaxation

Postdural puncture headache is one of the well-known complications of spinal anesthesia. The sitting position is adequate for perineal and urologic operations, or when obesity makes difficult identification of midline anatomy in the lateral position. This study was done to see the effect of position (lateral or sitting position during spinal anesthesia), needle bevel direction (parallel or vertical to longitudinal dural fiber), and angle of approach (paramedian or midline) on the incidence, onset, location, severity of postdural puncture headache in the 160 patients underwent spinal anesthesia with 25-gauge Quincke needles. We observe the following results: 1) The total incidence of postdural puncture headache was 8.1%(13 cases). 2) The incidence of postdural puncture headache were 6%(lateral position), l0%(sitting position), 3%(parallel to longitudinal dural fiber), 11%(vertical to longitudinal dural fiber), 8%(paramedian approach) and 9%(midline approach). A significant increase in incidence was found with 25-gauge Quincke needles when the bevels were oriented so as to be vertical rather than parallel to the longitudinal dural fibers. 3) The onset of postdural puncture headache were within 3 days after spinal anesthesia in the almost cases (92.3%). 4) The location of postdural puncture headache were frontal(31%), occipital(15%), temporal(8%), and whole region(46%). 5) According to the duration of postdural puncture headache, two day headache was 31%, four day one was 15%, six day one was 15%, and over six day one was 38%. A significant increase in duration was found with sitting position when the bevels were oriented so as to bc vertical rather than parallel to the longitudinal dural fibers. 6) The treatments of postdural puncture headache were bed rest(20%), analgesics(54%), and epidural blood patch(31%). In conclusion, the significant increase in incidence and duration were found with 25-gauge Quincke needles when the bevels were oriented so as to be vertical rather than parallel to the longitudinal dural fibers.
Anesthesia, Spinal* ; Headache ; Humans ; Incidence ; Needles* ; Obesity ; Post-Dural Puncture Headache*