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British Journal of Anaesthesia, 2000, Vol. 85, No. 2 238-241
© 2000 The Board of Management and Trustees of the British Journal of Anaesthesia

How much work is required to puncture dura with Tuohy needles?

M. C. Lewis*, J. P. Lafferty, M. S. Sacks, V. S. Pallares and M. TerRiet

Departments of Anesthesiology, and Biomedical Engineering, Veterans Affairs Medical Center/Jackson Memorial Medical Center, University of Miami, Miami, FL, USA

The effects of needle bevel orientation and cerebrospinal fluid (CSF) pressure on dural displacement and force required to penetrate cadaveric dura were studied using 40 samples. A constant hydrostatic pressure was applied to the subdural surface, either high or low, simulating the sitting and lateral positions. A 17-gauge Tuohy needle was advanced through the dura with the bevel oriented parallel or perpendicular to dural fibres. Travel distance and peak force at which dural penetration occurred were measured under both pressure conditions. The work required to produce dural penetration was calculated. Greater force and work were required to penetrate dura in the perpendicular orientation (P<0.05), regardless of the subdural pressure exerted. Dural displacement was similar under both pressure conditions.

Br J Anaesth 2000; 85: 238–41

* Corresponding author: Anesthesiology Service (139), Veterans Affairs Medical Center, 1201 NW 16th Street, Miami, FL 33125, USA


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