P149 Severe deformation of a spinal needle during subarachnoid anesthesia

<h3></h3> <b>Please confirm that an ethics committee approval has been applied for or granted</b>: Not relevant (see information at the bottom of this page) <h3>Background and Aims</h3> Needle breakage or deformation during spinal anesthesia occurs infrequently and represents a serious complication with potentially adverse effects.Several case reports were published to deal with this rare complication and address the topic while looking at the incidence, risk factors, and ways to prevent broken or deformated needles while receiving spinal anesthesia. There are a number of risk factors that are associated with potential deformation or fracture of spinal needles during subarachnoid anaesthesia. <h3>Methods</h3> We report a case of a deformated spinal needle into a zingzang shape, while perfoming a subarachroid anesthesia in an obese woman(BMI= 68) indicated for an emergent trimalleoral fracture. <h3>Results</h3> Multiple puncture attempts due to difficult identification of lumbar spine, the lack of experience of the resident, the low-quality of the equipment, the lack of expiriense in using the urltasound and the extra high BMI of the patient 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. <h3>Conclusions</h3> Spinal needles are designed and manufactured to be strong and durable. However, factors such as improper use, manufacturing defects, or accidental trauma can potentially lead to needle breakage. The use of proper techniques, the use of ultrasound, the use of high-quality equipment, and adherence to safety guidelines significantly reduce the risk of such incidents.