An epidural nerve block is widely and often effectively used for treating pains. However, it has risks of severe complications, such as epidural hematoma and nerve injuries. Because a blind puncture is generally employed, it is impossible to grasp the relative arrangement of the needle tip, blood vessels, and nerves. However, use of a dull-ended Tuohy needle (dull needle) can reduce tissue damage caused by a sharp needle point. Moreover, puncture resistance increases, which may relay the sensation much more clearly when the ligament is pierced. Therefore we used conventional Tuohy needles and dull needles for epidural block cases to compare the presence of piercing sensation, puncture frequency, level of bleeding, and presence of pain at the insertion. As a result, in the dull needle group significantly many cases were recognized to have the piercing sensation, and significantly few cases of bleeding needed compression at the puncture site. It is suggested that use of the dull needle may reduce the risk of complications.
View full abstract