SynthesisMedicine2017
Comparison of cutting and pencil-point spinal needle in spinal anesthesia regarding postdural puncture headache: A meta-analysis.
Synthesis in Medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 52 citations in OpenAlex.
- Article
- Vibroacoustic signatures: proof of concept for simple material characterization during needle interventions.International journal of computer assisted radiology and surgery · 2025Article
- The Effects of Aromatherapy With Clove and Lavender on Headache Caused by Spinal Anesthesia in Patients Undergoing Urological Surgery: A Randomized Clinical Trial Study.Health science reports · 2025Article
- Efficacy and potency of sphenopalatine ganglion block for the management of postdural puncture headaches in post-cesarean section: A case report and literature review.The journal of obstetrics and gynaecology research · 2024Review
- Comparison of spinal anaesthesia and erector spinae plane block in unilateral inguinal hernia: Randomised clinical trial.Journal of minimal access surgery · 2024Article
- Review
- Spinal Introducer Needle Breakage During Spinal Anesthesia for Cesarean Section: A Case Report.Cureus · 2023Article
- Incidence and Severity of Post-dural Puncture Headache in Non-obstetric Patients Undergoing Subarachnoid Block.Cureus · 2023Article
- Incidence and Factors Associated with Postspinal Headache in Obstetric Mothers Who Underwent Spinal Anesthesia from a Tertiary Hospital in Western Uganda: A Prospective Cohort Study.Anesthesiology research and practice · 2023Article
- TEN-YEAR FOLLOW-UP OF QUALITY IN REGIONAL ANESTHESIA AND ANALGESIA IN OBSTETRICS OBSTETRIC REGIONAL ANESTHESIA: IMPROVING QUALITY.Acta clinica Croatica · 2022Article
- Postdural Puncture Headache-Risks and Current Treatment.Current pain and headache reports · 2022Review
- Rates of Epidural Blood Patch following Lumbar Puncture Comparing Atraumatic versus Bevel-Tip Needles Stratified for Body Mass Index.AJNR. American journal of neuroradiology · 2022Article
- Article
- Incidence and risk factors of postdural puncture headache: prospective cohort study design.Perioperative medicine (London, England) · 2020Article
- A Comprehensive Update on the Treatment and Management of Postdural Puncture Headache.Current pain and headache reports · 2020Review
- Article
- Incidence and management of post-dural puncture headache following spinal anaesthesia and accidental dural puncture from a non-obstetric hospital: A retrospective analysis.Indian journal of anaesthesia · 2018Article
- Spinal dura mater: biophysical characteristics relevant to medical device development.Journal of medical engineering & technology · 2018Review
- A Clinical Comparison between Single-Space Technique and Double-Space Technique for Combined Spinal and Epidural Anesthesia.Anesthesia, essays and researchesArticle
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPostdural puncture headache (PDPH), mainly resulting from the loss of cerebral spinal fluid (CSF), is a well-known iatrogenic complication of spinal anesthesia and diagnostic lumbar puncture. Spinal needles have been modified to minimize complications. Modifiable risk factors of PDPH mainly included needle size and needle shape. However, whether the incidence of PDPH is significantly different between cutting-point and pencil-point needles was controversial. Then we did a meta-analysis to assess the incidence of PDPH of cutting spinal needle and pencil-point spinal needle.
methodsWe included all randomly designed trials, assessing the clinical outcomes in patients given elective spinal anesthesia or diagnostic lumbar puncture with either cutting or pencil-point spinal needle as eligible studies. All selected studies and the risk of bias of them were assessed by 2 investigators. Clinical outcomes including success rates, frequency of PDPH, reported severe PDPH, and the use of epidural blood patch (EBP) were recorded as primary results. Results were evaluated using risk ratio (RR) with 95% confidence interval (CI) for dichotomous variables. Rev Man software (version 5.3) was used to analyze all appropriate data.
resultsTwenty-five randomized controlled trials (RCTs) were included in our study. The analysis result revealed that pencil-point spinal needle would result in lower rate of PDPH (RR 2.50; 95% CI [1.96, 3.19]; P < 0.00001) and severe PDPH (RR 3.27; 95% CI [2.15, 4.96]; P < 0.00001). Furthermore, EBP was less used in pencil-point spine needle group (RR 3.69; 95% CI [1.96, 6.95]; P < 0.0001).
conclusionsCurrent evidences suggest that pencil-point spinal needle was significantly superior compared with cutting spinal needle regarding the frequency of PDPH, PDPH severity, and the use of EBP. In view of this, we recommend the use of pencil-point spinal needle in spinal anesthesia and lumbar puncture.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.