Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Punctures”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed2004

Straight advancement of epidural catheter--comparative assessments by method and site of epidural needle puncture and angle of puncture.

The catheter straight advancement rate for introduction into the epidural space was investigated using a radiopaque catheter. One hundred patients were divided into two groups and underwent thoracic or lumbar epidural punctures, with one of two different puncture methods: the median approach or paramedian approach. Two different angles of epidural puncture needle insertion, 50-60 degrees and 90 degrees to skin surface plane, were used. A catheter was inserted into the epidural space about 5 cm cephalad and the course of the inserted catheter was ascertained by radiography. The results have shown that punctures performed at an insertion angle of 50-60 degrees yielded higher catheter straight advancement rates than those performed at an angle of 90 degrees in both thoracic and lumbar epidural punctures.

Anesthesia, Epidural↗
PubMed2004

Incidence of postdural puncture headache and backache, and success rate of dural puncture: comparison of two spinal needle designs.

OBJECTIVES: The goal of this randomized study was to compare the incidence of postdural puncture headache (PDPH) and postdural puncture backache (PDPB), and the success rate between two small-gauge spinal needle designs used in women undergoing subarachnoid block anesthesia. METHODS: After Institutional Review Board approval, 215 patients presenting for tubal ligation were randomly assigned to have 26-gauge Atraucan (AT group) or 25-gauge Whitacre (WH group) spinal needles used in their spinal anesthesia. The number of attempts to successful cerebrospinal fluid return and the success rate of the spinal blockade were documented. Postoperatively, an investigator blinded to the study interviewed patients daily. RESULTS: The incidence of PDPH was similar between the AT group (3.9%) and the WH group (4.0%). The total duration of all PDPHs was 5 days for the AT group and 15 days for the WH group. Both groups had a similar one-attempt success rate of 61% (AT group) and 62% (WH group). Failure to obtain cerebrospinal fluid occurred in only one in the AT group and two in the WH group. The incidence of PDPB was similar and the severity was mild in both groups. CONCLUSIONS: The low complication and failure rates make these two types of smaller size spinal needle design good candidates for dural puncture procedures, such as spinal anesthesia, diagnostic lumbar punctures, and myelograms.

Adult↗
PubMed1989

Bed rest and postlumbar puncture headache. The effectiveness of 24 hours' recumbency in reducing the incidence of postlumbar puncture headache.

A prospective, blind, randomised trial was undertaken to determine if the incidence of postlumbar puncture headache is significantly altered by 24 hours' recumbency. One hundred and two patients were allocated randomly to rest supine in bed for either 4 or 24 hours after spinal anaesthesia for urological or gynaecological surgery. A standardised spinal anaesthetic technique was applied that incorporated the use of a 22-gauge needle. All patients were followed-up prospectively to determine if there was a difference in the incidence of postlumbar puncture headache between the two groups. Five patients (11.6%) who were recumbent for 4 hours developed postlumbar puncture headache, a result which was not statistically significantly different from the seven patients (11.9%) in the other group who complained of postlumbar puncture headache.

Aged↗
PubMed1990

[Lhermitte's sign during lateral cervical puncture: survey of possible accidents in the lateral C1-C2 puncture and report of 2 cases of spinal cord penetration].

Lhermitte's sign was referred by two patients during lateral cervical puncture (LCP) due to accidental puncture of the spinal cord; no sequelae were observed in these patients. A brief review of the literature is presented, concerning: 1. Lhermitte's sign; 2. reported accidents during LCP. Avoidance of neural and/or vascular injuries is possible by employing the posterior approach to LCP (puncture of the dorsal spinal subarachnoid space at C1-C2). The lateral suboccipital puncture (at the atlanto-occipital space) of the cisterna magna is also recommended.

Adult↗
PubMed1987

[A new technic for preventing post-puncture complications following diagnostic lumbar puncture].

We investigated the clinical relevance of a new lumbar-puncture technique for prevention of headache. The spinal meninges were penetrated with a conventional puncture-needle with its bevel adjusted parallel to the main fibre direction, contrary to that in the usual technique. We used this method in 12 patients and only 1 complained of headache. On the other hand 9 patients out of 12 suffered from headache after conventional lumbar-puncture. These results demonstrate that post-lumbar puncture headache can be prevented by this technique in a high proportion of patients.

Adult↗
PubMed1989

[Ultrasound-controlled fine-needle puncture with a specially prepared puncture needle].

The described puncture needle with dual amplified point has been successfully applied at the Medical Clinic of the County Hospital Halle for more than half a year now. Better reflecting capacity in both vitro and vivo results from preparation of the needle point's surface. The more clear visibility of the needle point in the ultrasonic sectional view results in a better display during the whole process of puncture and makes possible a better locating also under difficult sonographic conditions. By the application of the described puncture needle the safety of the ultrasonic directed fine-needle puncture increases for both patient and examiner.

Biopsy, Needle↗
PubMed1999

Relief of postural post dural puncture headache by an epidural blood patch 12 months after dural puncture.

A 20-year-old previously healthy male presented at the pain clinic with chronic headache of about one year duration. Clinical examination revealed no pathological manifestations. During the consultation the patient was drinking Coca-Cola. On direct questioning he told that drinking Coca-Cola gave partial relief from the headache, and that the headache started after he had received two spinal anaesthetics for treatment of a lower leg fracture. Postural post dural puncture headache was now suspected and an epidural blood patch performed. Despite an interval of nearly 12 months since the dural punctures, a single epidural blood patch completely relieved the headache. This case history demonstrates that an epidural blood patch should be tried if a chronic post dural puncture headache is suspected.

Adult↗
PubMed1998

Prolonged impairment in activities of daily living due to postdural puncture headache after diagnostic lumbar puncture.

To assess the incidence of postdural puncture headache and its effects on patients' activities of daily living, we interviewed 325 adult patients subjected to a diagnostic lumbar puncture during a 1-year period. Two hundred and eighteen (67%) of the subjects replied to the questionnaire; 41 (19%) of these were diagnosed as having suffered a postdural puncture headache. Impairment of the activities of daily living persisting for 1 week or more was experienced by 16 (7%) of the subjects.

Activities of Daily Living↗
PubMed2002

Does ultrasound imaging before puncture facilitate internal jugular vein cannulation? Prospective randomized comparison with landmark-guided puncture in ventilated patients.

OBJECTIVE: To investigate whether prepuncture ultrasound evaluation of vascular anatomy facilitates internal jugular vein cannulation compared with landmark-guided puncture. DESIGN: Prospective randomized study. SETTING: Single community hospital. PARTICIPANTS: Adult patients undergoing general anesthesia (n = 240). INTERVENTIONS: The right internal jugular vein was cannulated using either anatomic landmarks or prepuncture ultrasound (3.75/7.5 MHz) guidance. In the landmark group, respiratory jugular venodilation was used as the primary landmark for locating the vein. Results of cannulation and the incidence of complications were compared. MEASUREMENTS AND MAIN RESULTS: Patients were randomly assigned to the ultrasound or landmark group. Respiratory jugular venodilation was identified in 188 patients (78.3%), in whom results of cannulation did not differ between the 2 techniques with respect to the venous access rate (cannulated at the first attempt: 83.5% in the landmark v 85.7% in the ultrasound group), the success rate (cannulated within 3 attempts: 96.9% v 95.6%), and the incidence of arterial puncture (1.0% v 3.3%). In the remaining 52 respiratory jugular venodilation-unidentified patients, the access rate (30.4% v 86.2%, p < 0.001) and the success rate (78.3 v 100%, p < 0.05) were significantly better in the ultrasound group, and no arterial puncture was recorded in the ultrasound group, whereas the incidence was 13.0% in the landmark group. The results were similar regardless of the ultrasound frequency used. CONCLUSION: Prepuncture ultrasound evaluation did not improve the result of right internal jugular vein cannulation compared with the respiratory jugular venodilation-guided approach. When the landmark was not observed, however, the prepuncture ultrasound guidance was helpful in facilitating the cannulation.

Adult↗
PubMed1995

[A new laser puncture guidance device for CT- and MRT-guided punctures of the trunk].

A stereotactic device was developed to facilitate CT- or MR-guided punctures of the body. The correct needle angulation is checked by the reflection of fan-shaped red and green laser beams upon the needle. Due to its principle of function and design the device has considerable advantages: The puncture angle can be controlled in three dimensions. The freedom of movement within the operation area will not be affected. The device does not have to be permanently installed and can be employed in MRI at any field strength. Furthermore, all kinds of puncture instruments can be used.

Biopsy, Needle↗
PubMed1989

[Does post-puncture syndrome following lumbar puncture depend on needle diameter?].

The impact of needle size on the frequency of post-lumbar puncture syndrome (PPS) was investigated in 77 patients undergoing diagnostic lumbar puncture. 22-gauge needles were used in 44 patients (group A) and 19-gauge needles in 33 (group B). Because of severe postdural headache, an epidural blood patch was applied in 6 patients and resulted in immediate relief of symptoms. In the remaining 71 patients, PPS occurred in 57% of group A and in 48% of group B. A statistically significant relationship could not be found between needle size and duration of PPS (p = 0.2), but an inverse ratio was found between age and duration of post-lumbar puncture headache (p = 0.006). A review of previous studies in this field shows that needles with a diameter smaller than 24 gauge reduce the incidence of PPS. However, technical skill is also of prime importance in lowering the frequency of postdural headache.

Adult↗
PubMedDate not supplied

Inadequate standard for glove puncture resistance: allows production of gloves with limited puncture resistance.

The National Fire Protection Association has developed standards for glove puncture resistance using a metal puncture probe. Biomechanical performance studies have demonstrated that glove puncture resistance to the probe is significantly greater than that of the hypodermic needle, suggesting that these standards have no clinical relevance. These standards give a false sense of security to health care personnel and sanction the production and use of gloves that give inadequate protection. The result is potentially harmful for medical personnel.

Equipment Design↗
PubMed1995

Puncture of submucosal and extrinsic tumors: is there a clinical need? Puncture techniques and their accuracy.

Cytological or histological tissue diagnosis of submucosal and extrinsic tumors adjacent to the upper gastrointestinal tract is required in many patients for differentiation of benign and malignant lesions. In the case of a submucosal lesion, it can be most efficiently obtained by transendoscopic needle puncture using a conventional endoscope and a guillotine needle device sampling histological tissue specimen. In the case of an extrinsic paraesophageal mass lesion in the dorsal mediastinum, transmural EUS-guided fine needle aspiration puncture appears to be an efficient technique for the differentiation of benign and malignant lesions. However, for transgastral or transduodenal EUS-guided FNA puncture, especially of pancreatic tumors, new prototypes of aspiration catheters with an extending steel needle are mandatory to obtain diagnostic tissue specimens.

Biopsy, Needle↗
PubMed1993

A new hemostatic puncture closure device for the immediate sealing of arterial puncture sites.

After angiography, 6 to 24 hours of bedrest is indicated to assure that adequate hemostasis of the femoral artery has been achieved. Recently, a new hemostatic puncture closure device (HPCD) has been developed, which consists of a resorbable polymer anchor, a resorbable suture, a small collagen plug and an 8Fr delivery device. The device is delivered into the femoral artery through the introducer sheath, the anchor is secured against the intraluminal artery wall, and the collagen plug is deployed on the arterial wall. The prototype of the HPCD was used in 20 patients administered heparin. After insertion of the HPCD, hemostasis was achieved in 1.2 +/- 2.1 minutes; in 2 patients a light pressure dressing was applied for 4 hours to stop oozing. No late bleeding occurred. In 1 patient the positioning suture broke, requiring the application of a pressure bandage. Patients were uneventfully mobilized after 6.7 +/- 3.5 hours. In all patients serial duplex scanning of the femoral artery was performed before and after 1, 7, 30 and 90 days after HPCD placement. In 5 patients a small subcutaneous hematoma close to the site of introduction could be detected by ultrasound 1 day after catheterization. All but 1 patient had normalization of the flow patterns in the femoral artery. It is concluded that: (1) the HPCD is an effective device to achieve immediate hemostasis after arterial catheterization despite antithrombotic therapy, (2) early mobilization was uneventful, (3) duplex ultrasound studies demonstrated only transient changes in the punctured femoral artery, and (4) further investigations are needed to establish the efficacy and safety of the device.

Equipment Design↗
PubMed2004

Comparison of 27-gauge (0.41-mm) Whitacre and Quincke spinal needles with respect to post-dural puncture headache and non-dural puncture headache.

BACKGROUND: The incidence of headache after spinal anaesthesia has varied greatly between studies. We compared the incidence of postoperative headache in general and postdural puncture headache (PDPH) when using 27-gauge (G) (outer diameter 0.41 mm) Quincke and Whitacre spinal needles in ambulatory surgery performed under spinal anaesthesia. METHODS: In a prospective, randomized study, 676 ASA physical status I-II day-case outpatients were given a spinal anaesthetic through either a 27-G (0.41 mm) Quincke or a 27-G (0.41 mm) Whitacre spinal needle. The incidence of any type of postoperative headache was assessed and the type of headache defined using a standardized questionnaire including PDPH criteria. The severity of the headache was defined using a 100-mm visual analogue scale. RESULTS: For the final analysis, 529 patients were available (259 patients in the Quincke group and 270 patients in the Whitacre group). The overall incidence of postoperative headache was 20.0%, but the incidence of true PDPH was very low (1.51%). The incidence of PDPH in the Quincke group was 2.70%, while in the Whitacre group it was only 0.37% (P < 0.05). The overall incidence of non-dural puncture headache was 18.5% and did not differ between the study groups. CONCLUSIONS: True PDPH seldom occurs when a 27-G (0.41 mm) spinal needle is used, although postoperatively a non-specific headache is common. Using the 27-G (0.41 mm) Whitacre spinal needle further reduced the incidence of PDPH. Thus, we recommend routine use of the 27-G (0.41 mm) Whitacre spinal needle when performing spinal anaesthesia.

Adult↗
PubMedDate not supplied

[Puncture of solid tumors of the liver with large caliber needle guided by ultrasonography. Study of 70 punctures].

Seventy specimens of solid hepatic tumors were obtained for histologic examination with a 18 G (1.2 mm) diameter needle under real-time ultrasound control. Overall sensitivity was 95.6 p. 100 while specificity was 100 p. 100. Distinction between primitive and secondary malignant tumor was possible in 91 p. 100 of cases. Transient hemorrhage at the puncture site occurred in one patient. These results attest to the superiority of guided puncture with a needle of sufficient caliber, thus allowing for correct histologic study. Side effects did not occur more frequently than with fine caliber needles.

Adult↗
PubMed1979

[Value of disk puncture in the diagnosis of infectious spondylodiskitis. Apropos of 48 punctures].

The authors report on their experience with discal puncture in the bacteriological diagnosis of 48 infectious spondylodiscites. This technique makes it possible to obtain a bacteriological certitude in 31 cases (65 per cent): Pott's disease (40 per cent) and 12 pyogene spondylodiscites (25 per cent), with 17 punctures remaining negative, including 5 technical failures, the needle not penetrating into the pinched disc. No incident was noted, demonstrating the harmless nature of this method. The authors insist upon the necessity of washing the disc in order to decrease the percentage of failures.

Bacterial Infections↗