Document Detail

Reliability of the 'pop' sign as an indicator of dural puncture during obstetric spinal anaesthesia: a prospective observational clinical study.
MedLine Citation:
PMID:  17635428     Owner:  NLM     Status:  MEDLINE    
Anaesthetists rely upon a loss of resistance and flow of cerebrospinal fluid to indicate when a spinal needle has breached the dura. The loss of resistance is not always felt, with the danger that the needle may be advanced into neurological tissue. One hundred women undergoing elective caesarean section were recruited and spinal anaesthesia, using a 27-G Whitacre needle, was performed using an incremental advancement technique. After each advancement of the needle, and before removing the stylet, it was recorded whether the anaesthetist had perceived any sign that the dura had been breached, and then whether cerebrospinal fluid had been obtained. Six patients were not included in the study due to technical difficulties. In 27 of 94 patients (29%) there was no clear tactile sign that the dura had been breached when cerebrospinal fluid was obtained. This study demonstrates that loss of resistance is not always felt when a 27-G spinal needle breaches the dura in the pregnant woman.
A Kathirgamanathan; N Hawkins
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anaesthesia     Volume:  62     ISSN:  0003-2409     ISO Abbreviation:  Anaesthesia     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-07-19     Completed Date:  2007-09-10     Revised Date:  2008-01-15    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  England    
Other Details:
Languages:  eng     Pagination:  802-5     Citation Subset:  AIM; IM    
City Campus, Nottingham University, Hospitals NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK.
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MeSH Terms
Anesthesia, Obstetrical / methods*
Anesthesia, Spinal / methods*
Cesarean Section*
Clinical Competence
Dura Mater
Medical Staff, Hospital
Prospective Studies
Spinal Puncture / methods*
Treatment Failure
Comment In:
Anaesthesia. 2008 Jan;63(1):100; author reply 100-1   [PMID:  18086085 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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