PMID: 9168220May 1, 1997Paper

Bevel direction, dura geometry, and hole size in membrane puncture: laboratory report

Regional Anesthesia
P M Kempen, C K Mocek

Abstract

The cylindrical shape of the dura in vivo, as well as the needle tip deviation known to occur with beveled needle insertion, might predispose to geometric effects of needle orientation on hole size and shape during dural puncture. The object of this study was to investigate such possible effects. Standard xerographic paper was used to simulate a dura mater membrane with random fiber orientation. Rigidly mounted paper cylinders of 2-cm diameter were transfixed at 90 degrees angles to the cylinder axis with 22-gauge Quincke point spinal needles. A nonrotating drill press effected linear insertion, creating entry and exit perforations at median and paramedian positions. The bevel direction was rotated at 90 degrees angles during punctures in order to determine the effects of lateral versus transverse bevel orientation (relative to the cylinder axis) on the resultant hole morphology. With median perforation, all holes (entry and exit) were of uniform size and shape regardless of bevel orientation. Paramedian perforations of the cylinder at near tangential positions, with the bevel directed lateral to the cylinder axis, resulted in formation of a flap overlapping the margins of either the entry or exit hole but not both. Flaps forme...Continue Reading

Citations

Jul 13, 2006·The Neurologist·Jeffrey M RichmanChristopher L Wu
Jul 28, 2005·Acta Anaesthesiologica Scandinavica·H ViitanenM Heikkilä
Oct 3, 2006·Current Opinion in Anaesthesiology·S Longo
Jul 31, 2012·Cephalalgia : an International Journal of Headache·Jane A AmorimMarcelo M Valença
Nov 24, 2001·Journal of Pediatric Oncology Nursing : Official Journal of the Association of Pediatric Oncology Nurses·C Chordas

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