Broken needle during spinal anesthesia: an avoidable complication

Abstract

Rawéléguinbasba Armel Flavien Kabore,1 Ibrahim Alain Traore,2 Salah Idriss Séif Traore,3 Cheik Tidiane Hafi Wind-Pouiré Bougouma,1 Pascal Augustin,4 Aboudoul-Fataou Ouro-Bang’na Maman5 1Department of Anesthesia, University Hospital Blaise Comparoé, Ouagadougou, Burkina Faso; 2Department of Anesthesia, Uiversity Hospital Sourou Sanou, Bobo Dioulasso, Burkina Faso; 3Department of Anesthesia, District Hospital of Bogodogo, Ouagadougou, Burkina Faso; 4Department of Anesthesia, Intercommunity Hospital of Meulan, Les Mureaux, Meulan en Yvelines, France; 5Department of Anesthesia, Ales-en-Cévennes Hospital, Alès-en-Cévennes, France Abstract: The occurrence of a needle breaking is a very rare complication of spinal anesthesia (SA). We report a case of a broken spinal needle occurring in a morbid obese pregnant woman during SA indicated for an emergent cesarean section. Multiple puncture attempts due to difficult identification of lumbar spine, associated with an inadequate use of the introducer, contributed to this complication. The recognition of predictive factors for difficult neuraxial anesthesia, the use of ultrasound in obese patients, and a properly executed technique may have allowed avoiding this complication. Keywords: spinal anesthesia, needle breaking, cesarean section, obesit