A comparison of three different gauge Quincke’s spinal needles in patients undergoing elective surgery under spinal anaesthesia: a prospective randomized study

Background: The present study was conducted to compare three different Quincke’s spinal needles i.e. 23, 25 and 26 gauge in patients undergoing elective surgery under spinal anaesthesia (SA).Methods: The prospective randomized double-blind study was conducted on 150 male patients in the age group of 18-50 yrs., having physical status class I to II, scheduled for elective surgery under SA. Patients were randomly divided into three groups comprising 50 patients each. SA was administered using Quincke’s spinal needles of 23, 25 and 26 gauge in group 1, 2 and 3 respectively. Ease of insertion, number of attempts and time of appearance of CSF and incidence of PDPH was recorded in all the patients.Results: Ease of insertion was graded easy in 98%, 84% and 82% in group 1, 2 and 3 respectively. First attempt success rate was highest in group 1, (98%). Meantime for appearance of CSF beyond hub was maximum in group 3 i.e. 14.60±2.56 sec. Mild PDPH was reported in 6% and 2% patients after 24 hrs in group 1 and group 2 respectively.Conclusions: Finer spinal needle proved to be more dependable in generating less traumatic effect on the dura and preventing PDPH but are technically more difficult thus decreasing first attempt success rate.

Oral clonidine versus gabapentin as premedicant for obtunding hemodynamic response to laryngoscopy and tracheal intubation

We compared the effects of oral clonidine and gabapentin as premedicant in obtunding hemodynamic response to laryngoscopy and intubation in normotensive patients undergoing elective surgery. A total of 100 patients of either sex enrolled in the study were randomly divided into two groups of 50 each. Group A patients received oral clonidine 200 microg and Group B patients received oral gabapentin 900 mg, 90 min prior to induction of anesthesia. Both groups were matched for age, sex weight and intubation time. Anxiety score and sedation scores before induction were significantly better in Group A as compared with Group B. Heart rate rise was obtunded in Group A except at 1 min, as compared with Group B in which tachycardia persisted even at 3 and 5 min following intubation. Mean arterial pressure was maintained below baseline at all times in Group A as compared with Group B in which significant rise [+7.55%, P < 0.001] was seen at 1 min after intubation. Oral clonidine provided good attenuation of hemodynamic response to laryngoscopy and intubation as compared with oral gabapentin.