Comparison of Sprotte and Quincke Spinal Needles on the Frequency and Severity of Transient Neurologic Syndrome (TNS) after Spinal Anesthesia in Patients undergoing Cesarean Delivery: A Randomized Clinical Trial

Abstract

Transient neurologic syndrome (TNS) is a complication of spinal and epidural anesthesia with low incidence. TNS is defined as postoperative bilateral and symmetrical back or buttocks pain radiating to the lower extremities with no neurologic deficits. There are several causes for TNS. Due to very few studies on the effect of spinal needle type on the prevalence of TNS, this study was performed to compare Sprotte and Quincke spinal needles in the frequency and severity of TNS after spinal anesthesia in patients undergoing cesarean delivery. Materials and Methods: This randomized and single-blind clinical trial was performed on 160 full-term and singleton pregnant women aged 18-40 years, ASA class I, and undergoing elective cesarean delivery with spinal anesthesia. Patients were randomly divided into two groups in terms of needle type (Sprotte or Quincke). In study group (n=80) spinal anesthesia was performed using Sprotte spinal needle G. 25 and in control group (n=80) with Quincke spinal needle G. 25. Patients were evaluated for the frequency, severity, onset and duration of TNS symptoms up to 48 hours after recovery from spinal anesthesia. The type and dose of analgesics used to treat the symptoms and ultimately the outcomes were recorded. Results: The frequency of TNS in all patients was 5.6% (9 cases). There was no statistically significant difference in the frequency of TNS between the two study groups (3.8 vs. 7.5; p=0.303). However, the frequency of symptoms was lower in patients of the study group. There was no statistically significant difference in pain intensity, onset time and duration of symptoms between patients in the two study groups. Also, no statistically significant difference was observed between the two study groups in terms of the frequency of paresthesia (p=0.468) and motor weakness (p=0.560) after surgery. PDHD was observed in 3 (1.9%) patients of control group.