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Background <p>Spinal anesthesia using a 25G pencil-point needle (SSA) results in less local trauma compared to the conventional needle-through-needle (19G-25G) spinal anesthesia technique (CSA), which uses a thinner needle. The present study aimed to compare the short-term outcomes of intraspinal puncture in cesarean delivery between SSA and CSA.</p> Patients and methods <p>Parturients who underwent an elective cesarean delivery between September 17 and November 30, 2022 were randomized into Group SSA or Group CSA using block randomization. The SSA group received single-shot spinal anesthesia with a 25G pencil-point needle, whereas the CSA group received conventional spinal anesthesia using the needle-through-needle (19G-25G) technique. The primary outcomes included the numeric rating scale pain score during intraspinal puncture and the incidence of low back pain within three months postdelivery. Data analyses were conducted using the modified intention-to-treat principle and per-protocol analysis.</p> Results <p>A total of 172 participants were included in the primary outcome mITT analysis (87 in the CSA group and 85 in the SSA group). Of these, 152 participants completed the three-month assessments. The numeric rating scale scores during intraspinal puncture were significantly lower in the SSA group compared to the CSA group (SSA-CSA difference of −&#xa0;1.0, 95% CI −&#xa0;2.0 to −&#xa0;1.0; <i>P</i> &lt; 0.0001). The incidence of low back pain at 1&#xa0;month postdelivery was significantly lower in the SSA group compared to the CSA group (43.2% vs. 61.5%, <i>P</i> = 0.022). Multivariate binary logistic regression showed that the SSA technique reduced the risk of low back pain at 1&#xa0;month (OR 0.410, 95% CI 0.201 to 0.836; <i>P</i> = 0.014).</p> Conclusion <p>Compared with the CSA technique, the SSA technique reduced the numeric rating scale scores during intraspinal puncture, and may help alleviate postpartum low back pain, particularly at one month postpartum. Further prospective cohort studies with larger sample sizes are needed to better assess the benefits of the SSA technique.</p> Trial registration <p>Chinese Clinical Trial Registry Identifier: ChiCTR2200063820</p>

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Spinal anesthesia with a 25G pencil-point needle for cesarean delivery: a prospective, randomized controlled trial

  • 期刊论文

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  • 发表日期：

    2026年4月9日

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  • Yan He,
  • Xiao-Xuan Wu,
  • Yong-Bo Hou,
  • Ke Xu,
  • Hao Sun,
  • Hai-Juan Zhu

摘要

Background

Spinal anesthesia using a 25G pencil-point needle (SSA) results in less local trauma compared to the conventional needle-through-needle (19G-25G) spinal anesthesia technique (CSA), which uses a thinner needle. The present study aimed to compare the short-term outcomes of intraspinal puncture in cesarean delivery between SSA and CSA.

Patients and methods

Parturients who underwent an elective cesarean delivery between September 17 and November 30, 2022 were randomized into Group SSA or Group CSA using block randomization. The SSA group received single-shot spinal anesthesia with a 25G pencil-point needle, whereas the CSA group received conventional spinal anesthesia using the needle-through-needle (19G-25G) technique. The primary outcomes included the numeric rating scale pain score during intraspinal puncture and the incidence of low back pain within three months postdelivery. Data analyses were conducted using the modified intention-to-treat principle and per-protocol analysis.

Results

A total of 172 participants were included in the primary outcome mITT analysis (87 in the CSA group and 85 in the SSA group). Of these, 152 participants completed the three-month assessments. The numeric rating scale scores during intraspinal puncture were significantly lower in the SSA group compared to the CSA group (SSA-CSA difference of − 1.0, 95% CI − 2.0 to − 1.0; P < 0.0001). The incidence of low back pain at 1 month postdelivery was significantly lower in the SSA group compared to the CSA group (43.2% vs. 61.5%, P = 0.022). Multivariate binary logistic regression showed that the SSA technique reduced the risk of low back pain at 1 month (OR 0.410, 95% CI 0.201 to 0.836; P = 0.014).

Conclusion

Compared with the CSA technique, the SSA technique reduced the numeric rating scale scores during intraspinal puncture, and may help alleviate postpartum low back pain, particularly at one month postpartum. Further prospective cohort studies with larger sample sizes are needed to better assess the benefits of the SSA technique.

Trial registration

Chinese Clinical Trial Registry Identifier: ChiCTR2200063820