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Observations on deliberate dural puncture with a Tuohy needle: depth measurements
Author(s) -
HOLLWAY T. E.,
TELFORD R. J.
Publication year - 1991
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1991.tb09764.x
Subject(s) - tuohy needle , medicine , dura mater , epidural space , surgery , percutaneous , seldinger technique
Summary Observations were made during the use of a Tuohy needle to perform deliberate dural puncture for the insertion of lumbar drains to improve operating conditions for intracranial aneurysm surgery. The most striking finding was the distance from identification of the epidural space to penetration of the dura. We postulate that this was because of tenting of the dura by the blunt Tuohy needle. This was facilitated by the absence of a negative epidural space pressure because an open system was used, which allowed time for pressure equilibration. This minimised the reactive forces across the dura. Aspiration and rotation of the Tuohy needle revealed dural puncture in some cases.