[Incidence of headache following intradural anesthesia with 26 gauge needles depending on whether the punction is done with the bevel perpendicular or parallel to the dura mater fibers].
OBJECTIVE
To determine the incidence of headache after lumbar puncture, we prospectively studied 270 patients who underwent intradural anesthesia for programmed urologic, traumatologic, general, and gynaecologic surgery.


METHODS
The mean age of the patients was 55.6 +/- 16.9 years. There were significant differences between the age of women (54.8 +/- 15.5 years) and men (56.4 +/- 18.4 years). Intradural anesthesia was performed with a Becton-Dickinson 26G needle with a Quincke tip. Patients were randomly divided into two groups according to that puncture was directed parallel (group 1) or perpendicular (group 2) to the dura-mater fibers. When the spinal liquid dripped through the needle, 2 ml of a 0.75% (15 mg) solution of bupivacaine and 0.2 ml of a 50% (100 mg) solution of glucose were injected. No special measures were undertaken during the postoperative phase. The incidence of headache was analyzed 72 hours after puncture.


RESULTS
One patient of group 1 (0.66%) and 6 patients of group 2 (5%) presented headache. This difference was not statistically significant. Differences between the incidence of headache in women (4.05%) and in men (2.15%) were also not significant.
Casagrán
B
B
Servicio de Anestesiología y Reanimación, Clínica Girona.
Busquets
A
A
Brull
J
J
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000775:Anesthesia, Spinal / Q000379:methods*; D005260:Female; D006261:Headache / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009339:Needles; D011446:Prospective Studies; D011677:Punctures / Q000379:methods*
Incidencia de cefaleas tras anestesia intradural con agujas del número 26 según que la punción sea con el bisel perpendicular o paralelo a las fibras de la duramadre.