title: Incidence of postdural puncture headache and backache, and success rate of dural puncture: comparison of two spinal needle designs.
abstract: OBJECTIVE
  The goal of this randomized study was to compare the incidence of postdural puncture headache (PDPH) and postdural puncture backache (PDPB), and the success rate between two small-gauge spinal needle designs used in women undergoing subarachnoid block anesthesia.
  
  
  METHODS
  After Institutional Review Board approval, 215 patients presenting for tubal ligation were randomly assigned to have 26-gauge Atraucan (AT group) or 25-gauge Whitacre (WH group) spinal needles used in their spinal anesthesia. The number of attempts to successful cerebrospinal fluid return and the success rate of the spinal blockade were documented. Postoperatively, an investigator blinded to the study interviewed patients daily.
  
  
  RESULTS
  The incidence of PDPH was similar between the AT group (3.9%) and the WH group (4.0%). The total duration of all PDPHs was 5 days for the AT group and 15 days for the WH group. Both groups had a similar one-attempt success rate of 61% (AT group) and 62% (WH group). Failure to obtain cerebrospinal fluid occurred in only one in the AT group and two in the WH group. The incidence of PDPB was similar and the severity was mild in both groups.
  
  
  CONCLUSIONS
  The low complication and failure rates make these two types of smaller size spinal needle design good candidates for dural puncture procedures, such as spinal anesthesia, diagnostic lumbar punctures, and myelograms.
authors.affiliation: Department of Anesthesiology, Wake Forest University, Winston-Salem, NC, USA. ppan@wfubmc.edu
authors.forename: Peter H
authors.initials: PH
authors.lastname: Pan
authors.forename: Regina
authors.initials: R
authors.lastname: Fragneto
authors.forename: Charles
authors.initials: C
authors.lastname: Moore
authors.forename: Vernon
authors.initials: V
authors.lastname: Ross
mesh_terms: D000328:Adult; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000295:instrumentation*; D001416:Back Pain / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006261:Headache / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D009339:Needles / Q000009:adverse effects; D049590:Postpartum Period; D013129:Spinal Puncture / Q000009:adverse effects / Q000295:instrumentation*; D013246:Sterilization, Tubal