Post-dural puncture headache in young orthopaedic in-patients: comparison of a 0.33 mm (29-gauge) Quincke-type with a 0.7 mm (22-gauge) Whitacre spinal needle in 200 patients.
The incidence of postdural puncture headache (PDPH) following spinal anaesthesia with a 0.33 mm (29-gauge) and two types of 0.7 mm (22-gauge) Whitacre needles was investigated in 400 patients less than 40 years old. The incidence of PDPH was 2% in the 0.33 mm group, and 3.5% in the 0.7 mm group. Headache of other origin was seen in 12 patients (6%) in the 0.33 mm and in five patients (2.5%) in the 0.7 mm group. These differences were not significant. The failure rate was significantly higher in the 0.33 mm group (8.5% vs 2%) than in the 0.7 mm group (P less than 0.05). It is concluded that the 0.33 mm needle is associated with a low incidence of PDPH in young patients, but has a significantly higher failure rate than the Whitacre 0.7 mm needle, which is also a suitable choice in this age-group because of its ease of handling and the low incidence of PDPH.
Lynch
J
J
Department of Anaesthetics, Dreifaltigkeitskrankenhaus, Köln, West Germany.
Arhelger
S
S
Krings-Ernst
I
I
D000293:Adolescent; D000328:Adult; D000775:Anesthesia, Spinal / Q000009:adverse effects* / Q000295:instrumentation; D002045:Bupivacaine / Q000008:administration & dosage; D002555:Cerebrospinal Fluid; D004388:Dura Mater; D004867:Equipment Design; D005260:Female; D006261:Headache / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008297:Male; D009339:Needles; D011187:Posture; D013129:Spinal Puncture / Q000295:instrumentation*; D013499:Surface Properties
D002045:Bupivacaine