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Atraumatic Needles for Spinal Anesthesia

Choose Pencan® – because needle design matters.

Spinal anesthesia is widely used, yet 5–8% of attempts fail1, often requiring conversion to general anesthesia—causing delays, discomfort, and higher complication risks like post-dural puncture headache (PDPH).
Discover how needle design impacts spinal anesthesia success.2
Learn why atraumatic Pencan® needles reduce PDPH risk and improve patient safety.​

Spinal Anesthesia

Failure Rate

  • up to

    0%

Discover how needle design impacts spinal anesthesia success.
Learn why atraumatic Pencan® needles reduce PDPH risk and improve patient safety.

Pencan®: The Preferred Choice for Spinal Anesthesia and Lumbar Puncture

Clinical guidelines and systematic reviews consistently endorse atraumatic, pencil-point needles as the superior option for spinal anesthesia and lumbar puncture.3 The atraumatic, ogival tip of Pencan® separates dural fibers rather than cutting them, reducing Cerebrospinal Fluid (CSF) leakage and tissue damage.​4
Compared to traditional cutting-tip designs, Pencan® significantly lowers the risk of post-dural puncture headache, enhances patient safety, and improves overall procedural outcomes.5

Clinical data show that the use of Pencan® significantly reduces the incidence of post-lumbar puncture headaches—from 7.6% with conventional needles to just 2.3%. In addition, the need for an epidural blood patch is markedly lower, decreasing from 1.8% to only 0.5%. 

Close-up comparison of a sharp medical needle puncturing skin on the left and a small healed puncture mark on the right, both shown against a light skin-toned background

Pencan® - atraumatic needle:

Advanced technology for decreasing incidence of post lumbar puncture headaches.

Close-up comparison showing a beveled medical needle tip on the left and a small puncture mark on skin on the right, both against a light skin-toned background

Quincke - cutting needle:

One risk factor for post lumbar puncture headaches is the use of Quincke needle.

General benefits of Pencan®
compared to cutting needles ​

  • Reduced Risk of PDPH
  • Less tissue trauma
  • Lower Risk of Bleeding and Swelling
  • Enhanced Procedural Control: Designed for high flowrates and rapid CSF appearance

 

Design details that make a difference

It is well established that atraumatic needle designs help reduce the risk of PDPH. However, atraumatic needles vary significantly between manufacturers in terms of tip geometry, orifice length, and eyelet positioning6. These differences can impact performance, safety, and user experience.7  Choosing the right atraumatic needle is essential—not just any atraumatic needle will do.

Illustration comparing Pencan, Sprotte, and Whitacre spinal needles with labeled tip designs and measurements in millimeters

Precision Matters: Reduce the risk of failed blocks

To deliver anesthetic effectively, the spinal needle must pass through several anatomical layers: skin, subcutaneous tissue, ligaments, and the dura mater. Success is confirmed by the appearance of CSF in the needle hub. However, needle design affects how reliably and safely this confirmation occurs. Poorly designed needles can result in partial placement, where the orifice lies between the subarachnoid and epidural spaces. This can lead to incomplete drug delivery and failed anesthesia, despite apparent CSF flashback 8 (Fig 1)

A shorter tip-to-back-of-eyelet distance helps minimize the insertion depth of the needle tip into the subarachnoid space, reducing the risk of nerve contact and ultimately lowering the chance of paresthesia.9 ( Fig.2) It also enables faster CSF return for better control during placement.

A spinal needle tip positioned near tissue layers, showing anatomical structures in cross-section with colored regions for muscle, dura, and nerve bundle

Fig.1

Two spinal needle tips positioned near tissue layers, with the lower needle highlighted in red close to a nerve bundle

Fig.2

Why choose Pencan® as your atraumatic needle?

Support full intrathecal delivery and help to reduce the likelihood of partial or incomplete anesthesia.

Optimized eyelet positioning designed to enable faster CSF flashback, aiding correct and quick placement - reducing the need for multiple attempts.​

Provides a clear “dural pop” for tactile feedback, helps minimize nerve contact, and promotes a clean dural tear—associated with lower PDPH rates.​

Designed to reduce the risk of cauda equina contact, especially important in pediatric patients.

Related Documents

  • WHO recommendations

    Intrapartum care for a positive childbirth experience - WHO recommendations: intrapartum care for a positive childbirth experience

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  • WFSA Labour Analgesia Declaration

    Labour Analgesia Declaration – WFSA

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  • ASA Practice Guidelines for Obstetric Anesthesia

    An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology Anesthesiology

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  • ASA Statement on Neuraxial Analgesia or Anesthesia in Obstetrics

    Standards and Practice Parameters Statement on Neuraxial Anesthesia in Obstetrics

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References

1. Kinsella, S.M. (2008). A prospective audit of regional anaesthesia failure in 5080 Caesarean sections. Anaesthesia, 63(8), 822–832. doi: 10.1111/j.1365-2044.2008.05499.x.

2. Batova, R., & Georgiev, S. (2019). Impact of spinal needle design and approach on postdural puncture headache and spinal anesthesia failure in obstetrics. Anaesthesiology Intensive Therapy, 51(2), 77–82. doi: 10.5114/ait.2019.86166.

3. Nath, S., Koziarz, A., Badhiwala, J. H., et al. (2018). Atraumatic versus conventional lumbar puncture needles: A systematic review and meta-analysis. The Lancet, 391(10126), 1197–1204. https://doi.org/10.1016/S0140-6736(18)30493-6

4. Xu H, Liu Y, Song W, Kan S, Liu F, Zhang D, Ning G, Feng S. Comparison of cutting and pencil-point spinal needle in spinal anesthesia regarding postdural puncture headache: A meta-analysis. Medicine (Baltimore). 2017 Apr;96(14):e6527. doi: 10.1097/MD.0000000000006527. PMID: 28383416; PMCID: PMC5411200.

5. Reina, M. A., Puigdellívol-Sánchez, A., Gatt, S. P., De Andrés, J. A., Prats-Galino, A., & van Zundert, A. (2017). Electron microscopy of dural and arachnoid disruptions after subarachnoid block. Regional Anesthesia and Pain Medicine, 42(6), 709–718. https://doi.org/10.1097/AAP.0000000000000667

6. B. Braun technical data report, 2025

7. Reina, M. A., López, A., De Andrés, J. A., Prats-Galino, A., & van Zundert, A. (2007). Variability in the design of spinal needles: Implications for clinical practice. Regional Anesthesia and Pain Medicine, 32(4), 346–353. https://doi.org/10.1016/j.rapm.2007.02.006

8. Rae, J. D., & Fettes, P. D. W. (2023). Mechanisms and management of failed spinal anesthesia. NYSORA – The New York School of Regional Anesthesia. Retrieved from https://www.nysora.com/topics/complications/mechanisms-management-failed-spinal-anesthesia/

9. Reina MA, De Andres JA, Hernández JM, Arriazu Navarro R, Pastor J, Prats-Galino A. Looking for the development of paresthesias in the subarachnoid and epidural anesthesia: A clinical and anatomical analysis. Reg Anesth Pain Med. 2011;36(Suppl):E17–E22. doi:10.1097/AAP.0b013e3182030648. 

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