What kind of needle is used?

There are two main types or styles of needles used for dural puncture: sharp bevelled "cutting" needles with holes in the tip, and noninvasive pencil point needles with blunt tips and openings in the side of the needle. The two needle types are shown below. Examples of noninvasive pencil tip needles include Gertie Marx, Sprotte, and Whitacre needles.

Numerous studies and meta-analyses have shown that pencil tips are less invasive against the dura, with a lower risk of post-dural puncture headache or persistent dural defects. For routine diagnostic lumbar puncture, the literature clearly indicates that a smaller, noninvasive pencil tip needle is usually the needle type of choice. Although many anesthesia departments have adopted noninvasive types of needles, routine use in emergency department, outpatient, and inpatient Settings is not yet the standard of care nationwide.

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