P209: Selection of Spinal Needle Types for Cerebrospinal Fluid Collection in Clinical Trials

Poster Presenter

Akira Fujie

SOUSEIKAI Global
Japan

Objectives

The need for CSF collection continues to grow in psychoactive drug development. Postdural Puncture Headache (PDPH) is one of the most common complications after the procedure. In this study, we retrospectively analyzed various aspects of CSF sampling concerning the needle type.

Method

The data of 44 healthy elderly volunteers who underwent CSF collection at SOUSEIKAI Fukuoka Mirai Hospital were retrospectively analyzed. Three types of spinal needles were used: 21G non-cutting (Quincke) needles, 22G Quincke needles, and 22G pencil-point needles.

Results

The mean BMI was higher in the 21G group than the 22G group, however the time from local anesthesia to the beginning of CSF outflow was not different between the 21G and 22G groups. The CSF outflow speed was faster in the 21G group than the 22G group. Needle type in the 22G group (Quincke or pencil-point needle) did not affect the outflow. Two volunteers (6%) had headaches and 2 volunteers (6%) had heaviness of head in the Quincke needle group, but no volunteer (0%) had headaches or heaviness of head in the pencil-point needle group.

Conclusion

Due to the growing need for healthy elderly clinical trials, including CSF samplings at SOUSEIKAI, we have investigated the best procedures to ensure our subjects' safety and efficiently collect the samples. In the presented study, we retrospectively analyzed the data from CSF samplings performed as part of clinical trials at SOUSEIKAI. Since the CSF sampling had been done by lumbar puncture, we focused on 3 different needles for the spinal tap. We found that the CSF outflow speed was slower with the thinner needle and headaches and heaviness of the head only occurred in the group used Quincke type. It is concluded that it is possible to prevent PDPH while obtaining the required amount of CSF smoothly by carefully choosing spinal needle-type considering the amount of necessary CSF, burden of the subjects in the lateral position, and the incidence rate of complication.