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FILLERS: Smaller atraumatic needles are probably best for diagnostic lumbar punctures BMJ 2006; 333: 0-e [Abstract] [Full text]

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It depends how much CSF you want

Neville W Goodman   (23 November 2006)

It depends how much CSF you want 23 November 2006
Neville W Goodman, Consultant Anaesthetist Southmead Hospital, Bristol, BS10 5NB Send response to journal: Re: It depends how much CSF you want	Obstetric anaesthetists have for many years known that smaller spinal needles mean fewer headaches. But I can say from experience that a 24G needle is not suitable for a lumbar puncture if more than a few drops of cerebrospinal fluid are needed. Asked to give a spinal anaesthetic for caesarean section to a woman from whom the neurologists wanted 6 bottles each containing 10-15 drops for their various tests, I used a 24G needle. The flow was simply too slow, and I had to repeat the puncture with a 22G needle. I am pleased to say that the woman did not get a headache. Competing interests: None declared