Verifying spinal needle location in the presence of a 'dry tap'.

摘要

It is with great interest that I read the letter by Ramachandran and Ponnusamy describing successful spinal anesthesia after multiple attempts with a distinct "give", but no free flow of cerebrospinal fluid (CSF).1 The authors of this article should be commended for their cautious management of this infrequent clinical situation. I agree with the authors1 statement that "common sense dictates that the procedure be repeated, but if the outcome remains the same, and the patient refuses general anesthesia the options are limited." I would also like to point out other options that may be considered. Although radiological imaging with contrast may be impractical and cumbersome in some settings, this diagnostic approach would verify exact needle position prior to injection of the local anesthetic.