[Broken spinal needle: Clinical case and a brief review of the literature].

Abstract

Background: Spinal anesthesia can present various complications, one of which is the breakage of a spinal needle within the intrathecal space, which is one of the least frequent complications and it may be serious. A case of spinal needle breakage is presented, pointing out its risk factors and recommendations to reduce it.

Clinical case: 5-year-old female patient, who was scheduled for removal of translocated intrauterine device causing chronic pain. When attempting a spinal anesthesia, stylet was removed from the needle and directed into the subarachnoid space. Upon extraction, the spinal needle was deformed and shortened. Immediately and with fluoroscopy and local anesthesia, the broken fragment was extracted without complications. Regional anesthesia is widely used in pregnant women, as it is considered safe. However, there are factors that increase the probability of a spinal needle breakage (obesity, pregnancy, emergency procedures, incorrect handling of the spinal needle, etc.). Even so, there are various recommendations (use of ultrasound, proper handling of the needle, reducing the number of attempts, etc.) that can reduce the risk of spinal needle breakage.

Conclusion: Risk factors for spinal needle breakage should be identified, in order to decrease its incidence.