title: Post dural puncture headache in cesarean section: comparison of 25-gauge Whitacre with 25- and 26-gauge Quincke needles.
abstract: BACKGROUND
  Our previous study showed that there were no significant differences in the incidence of post dural puncture headache (PDPH) relevant to the use of 24 to 26-gauge Quincke spinal needles in obstetric patients. Again, we were eager to know if the pencil-point spinal needle (Whitacre) would be able to decrease the incidence of PDPH compared to Quincke spinal needle.
  
  
  METHODS
  We prospectively observed 94 spinal anesthesias for cesarean section performed during the period from May 1993 to July 1995. The 25-gauge Whitacre needles were used. In practice the insertion of needle was made through median line approach and the puncture was considered eligible only in one attempt. The PDPH was observed until its disappearance, and one without PDPH had also been observed for at least one week for likelihood of delayed occurrence. The data were compared with those of our previous study regarding the use of 25- and 26-gauge Quincke needles in obstetric patients. All of the data were analyzed using the Fisher exact test.
  
  
  RESULTS
  The incidence of PDPH was 1.06%. In comparison there was no significant difference from that of 25- and 26-gauge Quincke needles (3.65% and 2.06%, respective). Only one case suffered from PDPH in the Whitacre group. It was mild and relieved with bed rest and hydration.
  
  
  CONCLUSIONS
  Although the difference was not statistically significant, the 25-gauge Whitacre spinal needle caused a lower incidence and less severity of PDPH than the 25- and 26-gauge Quincke needles did.
authors.affiliation: Department of Anesthesiology, National Defense Medical Center/Tri-Service General Hospital, Taipei, Taiwan, R.O.C.
authors.forename: J J
authors.initials: JJ
authors.lastname: Hwang
authors.forename: S T
authors.initials: ST
authors.lastname: Ho
authors.forename: J J
authors.initials: JJ
authors.lastname: Wang
authors.forename: H S
authors.initials: HS
authors.lastname: Liu
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D002585:Cesarean Section; D005260:Female; D006261:Headache / Q000209:etiology*; D006801:Humans; D009339:Needles; D011247:Pregnancy; D011446:Prospective Studies; D013129:Spinal Puncture / Q000009:adverse effects*