22ga long whitacre

[kmurp]

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Anyone know if 22ga long spinal needles exist as a whitacre? Seeing a lot more big people and I'm thinking I would use them. Currently we only have long 22 ga quincke.

 

[IlDestriero]

They make anything and everything. Just order it from somewhere else if your supplier doesn't offer it. I think we have 6" sprotte needles, but I'm not sure who manufactures them.

 

[Orin]

I haven't seen 22g long whitacres, but there are some 25/27g if you really want one.

Is a whitacre necessary at that size for PDPH?

 

[IlDestriero]

Pajunk makes 22g sprottes to 150mm.
I'm not sure you need a bigger needle than that, you can always press the skin in. Most of the time the standard 3.5" is enough, with some adipose manipulation.
If that's not long enough, maybe a vet supply? 😉

 

[pgg]

Is a whitacre necessary at that size for PDPH?

The vast majority of the PDPH calls we get are from the ER after a neurologist did an LP with their barbaric 22g cutting needle.

Most of the time, if I reach for a 22g spinal needle, it's for an old person with a crunchy spine. Old patients don't seem to ever get PDPHs no matter what you pierce the dura with.

If for some reason I wanted a 22 for a young person I would definitely prefer a non-cutting type.

 

[okayplayer]

I haven't seen 22g long whitacres, but there are some 25/27g if you really want one.

Is a whitacre necessary at that size for PDPH?

In my limited experience, often the problem with the long 25g needles in the super morbid obese population is bending, even if used with an introducer. It would be nice to have a long 22g Whitacre for sure.

 

[GhostTree]

Where I'm at we have 150 mm Gertie Marx 22g pencil points, they are great for tough spinals in obese pts or ossified spines. Check them out

http://www.imd-inc.com/spinalanesthesia.php

 

[pgg]

In my limited experience, often the problem with the long 25g needles in the super morbid obese population is bending, even if used with an introducer. It would be nice to have a long 22g Whitacre for sure.

Long 25s will fit through CSE kit Tuohy needles ... that's a 10 cm introducer.

 

[kmurp]

Long 25s will fit through CSE kit Tuohy needles ... that's a 10 cm introducer.

Maybe that's the best solution. The long 25's don't track very true, I think. If you use an epidural first, then put the 25 through that, one might get a more reliable result.

 

[Jay K]

I love a 22G Whitacre, though I've never had to hub and indent that bad boy.