The frequency of postdural puncture headache in obstetric patients: a prospective study comparing the 24-gauge versus the 22-gauge Sprotte needle.
OBJECTIVE
To compare the frequency of postdural puncture headache (PDPH) in obstetric patients when using the 24-gauge or the larger 22-gauge Sprotte needle.


METHODS
Prospective, randomized study.


METHODS
Four hospitals.


METHODS
375 ASA physical status I and II cesarean section and postpartum tubal ligation patients.


METHODS
Obstetric patients were randomly assigned to receive spinal anesthesia via a midline dural puncture using the 24-gauge or the 22-gauge Sprotte needle.


RESULTS
The rate of PDPH was determined by a postoperative visit by the anesthesiologist as well as questioning patients by telephone 1 week or more after discharge. In the 24-gauge Sprotte needle group (n = 186), 2 mild and 1 moderate PDPHs were reported, for an overall rate of 1.61%. In the 22-gauge Sprotte needle group (n = 189), 2 mild and 1 moderate PDPHs were reported, for an overall rate of 1.59%. All headaches except 1 resolved within 72 hours with conservative treatment. One patient from the 22-gauge Sprotte needle group required an epidural blood patch. There were no failed blocks in either group.


CONCLUSIONS
Our results suggest that the 22-gauge Sprotte needle, when compared with the smaller 24-gauge Sprotte needle, can be used in obstetric patients without increasing the frequency of PDPH.
Sears
D H
DH
Department of Anesthesiology, Mercy Hospital and Medical Center, San Diego, CA 92103.
Leeman
M I
MI
Jassy
L J
LJ
O'Donnell
L A
LA
Allen
S G
SG
Reisner
L S
LS
D000328:Adult; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D002045:Bupivacaine; D002585:Cesarean Section; D005260:Female; D005283:Fentanyl; D006261:Headache / Q000209:etiology*; D006801:Humans; D008012:Lidocaine; D009020:Morphine; D009339:Needles; D011247:Pregnancy; D011446:Prospective Studies; D013129:Spinal Puncture / Q000009:adverse effects*; D013246:Sterilization, Tubal
D009020:Morphine; D008012:Lidocaine; D005283:Fentanyl; D002045:Bupivacaine