Comparison of 26- and 27-G needles for spinal anesthesia for ambulatory surgery patients.
Seven hundred thirty ambulatory surgery patients, randomly assigned to receive spinal anesthesia with a 26- or 27-G needle, were studied for the incidence of post-dural puncture headache (PDPH), postoperative back pain, and patient acceptance. The incidence of PDPH following the use of 26- and 27-G needles was 9.6% and 1.5%, respectively (P less than 0.05). The incidence of PDPH was 5.7% among men and 13.4% among women following the use of 26-G needles (P less than 0.05), whereas no difference between men and women was noted after the use of 27-G needles. Of the patients who were 40 yr of age or younger, the overall incidence of PDPH was 11.9%, with a 7.5% incidence among men and a 16.4% among women following the use of 26-G needles (P less than 0.05) and a 1.8% incidence of PDPH following the use of 27-G needles, with no statistical difference between genders. Postoperative back pain was experienced in 18.3% of the patients in the 26-G group and 20.2% in the 27-G group (difference not significant). Favorable acceptance of spinal anesthesia was reported in 89.4% of patients in the 26-G group and 98.2% in the 27-G group (P less than 0.01). Results from this study demonstrate that, in patients who received spinal anesthesia for ambulatory surgery, the use of 27-G needles resulted in a significantly lower incidence of PDPH and greater patient acceptance compared with the use of 26-G needles. The incidence of postoperative back pain was not significantly different between the two groups.
Kang
S B
SB
Gundersen Clinic-La Crosse Lutheran Hospital, Wisconsin 54601.
Goodnough
D E
DE
Lee
Y K
YK
Olson
R A
RA
Borshoff
J A
JA
Furlano
M M
MM
Krueger
L S
LS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000295:instrumentation; D000775:Anesthesia, Spinal / Q000295:instrumentation; D005260:Female; D006261:Headache / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D010342:Patient Acceptance of Health Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012737:Sex Factors