SMTL Medical Disposable Datacard

Spinal & epidural needles

Description

Spinal needles vary in their design, usually regarding the tip geometry, but are fundamentally similar and usually come with a stylet and introducer needle. Larger spinal needles may not require an introducer.  

Fig 1: A 'pencil point' spinal needle set with introducer and stylet/cannula

There are 2 designs of spinal needle tip in use within Wales at present :  the pencil point (on Whitacre and Sprotte needles) and the cutting tip on the Quinke (see below).

Fig 2: The tip and side hole of the Pencil point (also known as Whitacre)	Fig 3: Quinke (a short bevel with a cutting tip and no side opening)	Fig 4: Sprotte (Pencil tip needle with and elongated side opening)

In addition, epidural needles are also available, which have a larger bore compared to spinal needles, and are not sharp but  slightly curved near the tip to allow the epidural catheter to be threaded into the epidural space.

Fig 5: Tuohy needle (an epidural needle)

Key areas where used

• Theatres
• Delivery suites

Connectors

In Wales, all spinal needles currently use Luer connectors whilst some Trusts in England are using proprietary non-Luer connectors. Non-Luer connectors are designed to reduce the chance of wrong-route injections.

It is anticipated that when ISO 80369-6 is published, the UK and Wales will migrate to using a specific non-Luer compatible connector. Therefore at present the Welsh NHS continues to use Luer connectors in line with Welsh Government advice.  ISO 80369-6 is due to be published during late 2015, and medical devices using these connectors should be available in the UK during 2017.

Method of use

Spinal needles are used to inject analgesia and/or anaesthetic directly into the CSF usually at a point below the second lumbar vertebra. Spinal needles enter the cerebral spinal fluid (CSF) through the membranes surrounding the spinal cord. An introducer needle is used in some cases to stabilise the insertion of the needle and aid insertion through tough skin.  The needle and stylet are advanced towards the dura in the intevertebral space (the stylet stops tissue blocking the needle during insertion). An introducer needle is used in some cases to stabilise the insertion of the needle. Once through the dura and in position, the introducer is removed and the removal of the stylet enables CSF to flow into the needle hub.  CSF can be collected for diagnostic purposes or a syringe may be connected to the spinal needle to inject anaesthetic agents or chemotherapy agents. 

Whilst Quinke needles tend to cut through the dura (the tough outer membrane), pencil point designs such as the  Sprotte and Whitacre are designed to part the fibres of the dura rather than cut them, minimising damage to the dura fibres and reducing the risk of post-dural puncture headaches. 

Epidural needles (such as the Tuohy needle) are larger, hollow needles  that enter the epidural space.  The curve of the needle is designed to enable an inserted cannula to be threaded into the epidural space at an angle. Once the cannula is in place the epidural  needle is removed. Anaesthesia and analgesia can be administered via the epidural cannula. 

Presentation

Individually wrapped in a peel pouch

Sizes Required

• 70-150 mm needles (varies with needle type)
• 16-27G (varies with needle type)

Example products

The following table lists examples of products known to be acceptable for this product description.

Editors

P Phillips and J Ford

Please inform SMTL of any inaccuracies noted or changes required in this datacard.

Disclaimer

This datacard has been prepared as an aid to contracting for purchasers in the NHS in Wales, and should not be used as a substitute for literature, instructions or training from the manufacturers of the devices.

Products mentioned in this datacard are for illustration purposes only and should not be seen as an endorsement of these products.