• Rungsima Saenghirunvattana, Kamthorn Tantivitayatan, Wanna Chumnanvech, Supaporn Tangsukkasemsun, and Prapai Siritongtaworn.
• Department of Anesthesiology, Priest Hospital, Bangkok, Thailand. rangsima_sang@hotmail.com
• J Med Assoc Thai. 2008 Jan 1;91 Suppl 1:S156-61.

ObjectivesThe goal of this single blinded randomized study was to compare the use of routine cutting-tip spinal needle and newly-designed pencil-point Pajunk(AE) in terms of success rate, complications and satisfactions in priests undergoing spinal anesthesia for orthopedic, general and urological surgery at Priest Hospital, Thailand.Material And MethodAfter Institutional Review Board approval and patients' signed consent, from August 2006 to October 2007, 91 priests were randomly assigned to have 27-gauge Quincke (control group, C) or 25-gauge Pajunk(AE) (study group, S) spinal needles used in their spinal anesthesia. The number of attempts to successful cerebrospinal fluid return and the success rate of the spinal blockade were documented. Postoperatively, an investigator blinded to the study interviewed patients daily.ResultsThe first-time needling success rate for Quincke was 79% but for Pajunk(AE) only 46%, lower than reported. The incidence of minor complications was small, even there were 2 postoperative dead cases not related to anesthesia. Over 80% of both groups still preferred the same technique and surgeon satisfaction was good to excellent.ConclusionsThe newly-designed, pencil-point spinal needle was another example on the development of more refined towards quality anesthesia. To be cost-effective, it should be selected for patients at risk of CSF leakage-related complications.

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