The effect of needle type (25 G Sprotte vs. Quincke) in spinal anesthesia on the incidence of transient neurologic syndrome: A randomized clinical trial

TL;DR

This study compared two types of spinal needles to see which causes less back and buttock pain after surgery, finding that one needle type caused more severe pain.

Contribution

The study provides new evidence comparing the severity of postoperative pain between two commonly used spinal needle types.

Findings

45 out of 150 patients developed TNS, with no significant difference in incidence between the two needle types.

Patients in the Sprotte group experienced more severe pain (VAS 8–10) compared to the Quincke group.

TNS symptoms resolved within 2–3 hours for about half of the patients in both groups.

Abstract

Transient neurologic syndrome (TNS) is a postoperative pain in the back and buttock that can occur after spinal anesthesia. The spinal needle design may have an impact on the occurrence of TNS. We decided to compare the incidence of TNS and related factors between two spinal needle types.

In this randomized clinical trial, 150 patients aged 18–60 years and American Society of Anesthesiologists (ASA) physical status I who underwent lower abdomen or lower extremity surgeries with spinal anesthesia and supine position were enrolled. They were randomly divided into two groups (25 G Quincke or Sprotte needle) with 0.5% bupivacaine (12.5 mg). After the operation, the patients were asked to report any pain in the lower back, buttock, and thigh areas. A Visual Analog Scale (VAS) was also used to record the severity of the pain.

Overall, 45 patients developed TNS. Twenty‐nine patients in the Sprotte group (38.7%) and 16 patients in the Quincke group (21.3%) developed TNS (p = 0.75). More patients in the Sprotte group (25.3%) had severe pain (VAS score of 8–10) when compared with the Quincke group (6.7%). There was no significant difference in TNS symptoms duration between the two groups. In about half of patients (51.9%) in the Sprotte group and 57.3% of patients in the Quincke group, the symptoms resolved after 2–3 h.

Although the incidence of TNS did not differ significantly, patients for whom a Sprotte spinal needle had been used had more severe pain. This suggests that the Quincke needle caused less severe pain.