[Is local anesthesia necessary for spinal needle insertion?].

It is a routine procedure for anesthesiologists to use local anesthesia (LA) before spinal needle insertion (SNI), but LA itself produces pain on injection. We evaluated the necessity of LA before spinal block using a 25-gauge needle by questioning whether LA makes SNI painless and easy. Sixty patients without lumbar abnormality for spinal block were allocated to 3 groups: Group A, LA with 2 ml of 1% lidocaine using a 24-gauge needle; Group B, LA with 0.5 ml of 1% lidocaine using a 27-gauge needle; Group C, without LA. Visual analog pain scales of LA and SNI were obtained respectively. Though LA reduced the pain associated with SNI, total pain scales in Group A and Group B were significantly larger than those in Group C. The pain scale of LA was significantly lower in Group B than Group A, but there were no significant differences in the pain on SNI between the Groups. The times needed for SNI were not significantly different among the three Groups. In conclusion, LA with 2 ml of 1% lidocaine using a 24-gauge needle is not useful for pain relief on spinal block using a 25-gauge needle. Intradermal anesthesia using a 27-gauge needle is preferable to reduce the pain on SNI, if LA is necessary.

RCT Entities:   Population Interventions Outcomes