Accidental Dural Puncture With An Introducer Needle (18 G) For Elective Caesarean Section: A case report

A 23-year-old parturient with a body mass index of 20.8 kg/m2 at term was admitted for elective caesarean section. Spinal anaesthesia was done using a 27-G pencil-point needle without an introducer guide, with the usage of a separate 18-G introducer needle. After the introduction of the introducer at the level of L4–L5, accidental free flow of cerebrospinal fluid (CSF) was seen. The introducer was withdrawn and inserted at the level of L3–L4, followed by the spinal needle. CSF backflow was seen; an anaesthetic mixture was given. Block was successful and caesarean section was done with no intraoperative complications.