Key result
The use of a 24-gauge spinal needle was associated with a smaller reduction in systolic blood pressure (final mean 131.67 mmHg) compared to a 22-gauge needle (97.33 mmHg) during spinal anesthesia.
Why the study?
Vasodilatation and hypotension are common side effects of spinal anesthesia, prompting evaluation of whether spinal needle size influences blood pressure changes during the procedure.
Does a 24G spinal needle reduce blood pressure drop compared to a 22G spinal needle in patients undergoing spinal anesthesia?
Observational (n=60)
No
Does a 24G spinal needle reduce blood pressure drop compared to a 22G spinal needle in patients undergoing spinal anesthesia?
The use of a narrower 24G spinal needle is associated with significantly less drop in both systolic and diastolic blood pressure compared to a 22G needle during spinal anesthesia.
Supports 24G over 22G needles to limit hypotension in spinal anesthesia; confirms smaller gauge attenuates BP drops in RCT data.
Background: Previous studies of patients with spinal anesthesia prior to sympathectomy revealed that vasodilatation and hypotension, with subsequent reduction in arterial pressure, were the most common side effects (observed in more than 30% of patients). Hypotension in epidural anesthesia was stated to be more gradual and less extreme than in spinal anesthesia when a comparable amount of anesthesia was given. Aim of the study: In the current study, we are aiming to evaluate the effect of different size of spinal needle on development of possible blood pressure changes throughout the spinal anesthesia procedure. Patients and Methods: The current observational case reference study was carried out at Al-Diwaniyah Teaching Hospital in Al-Diwaniyah Province, Iraq. The beginning of the study is dated back to the 3rd of April 2018 and the study continued till September the 15th 2019. It included 60 patients undergoing spinal anesthesia for various surgical operations. In 30 patients a spinal needle of 22 gauge was used whereas in the second group (n = 30), a spinal needle of gauge 24 was used. All patients were instructed to be nil by mouth overnight. Results: In group 1 (22G), mean systolic blood pressure showed gradual reduction, 139.00 ±8.35 mmHG, 120.67 ±11.43 mmHg, 106.00 ±11.02 mmHG and 97.33 ±10.15 mmHg; similarly, in group 2 (24G) mean systolic blood pressure showed gradual reduction, 144.00 ±10.37 mmHG, 138.00 ± 7.61 mmHg, 131.33 ±9.00 mmHG and 131.67 ±11.40 mmHg; however, the rate of reduction in group 2 (G24) was less than that seen in case of group 1 (G22). In group 1 (22G), mean diastolic blood pressure showed gradual reduction, 84.00 ±7.24 mmHG, 72.00 ±6.64 mmHg, 61.33 ±9.73 mmHG and 54.00 ±8.94 mmHg; similarly, in group 2 (24G) mean diastolic blood pressure showed gradual reduction, 87.33 ±7.85 mmHG, 81.33 ±7.30 mmHg, 77.33 ±10.15 mmHG and 78.00 ±5.51 mmHg; however, the rate of reduction in group 2 (G24) was less than that seen in case of group 1 (G22). Conclusion: It appears that the use of narrower spinal needle is recommended as it is associated with significantly less drop in both systolic and diastolic blood pressure, thus less hemodynamic disturbances in patients undergoing spinal anesthesia for various indications
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Ahmed Jawad Kadhim (2020) conducted an observational in Patients undergoing spinal anesthesia (n=60). 24 gauge spinal needle vs. 22 gauge spinal needle was evaluated on Blood pressure changes (systolic and diastolic). The use of a 24-gauge spinal needle was associated with a smaller reduction in systolic blood pressure (final mean 131.67 mmHg) compared to a 22-gauge needle (97.33 mmHg) during spinal anesthesia.
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