Comparison of 25-gauge, Quincke and Whitacre needles for postdural puncture headache in obstetric patients.
OBJECTIVE
To compare the frequency of postdural puncture headache (PDPH) and failure rate of spinal anesthesia using 25-gauge Quincke and 25-gauge Whitacre needles in obstetric patients.


METHODS
Single blinded, interventional experimental study.


METHODS
This study was conducted at the Department of Anesthesiology, Pain Management and Surgical Intensive Care Unit, Dow University of Health Sciences and Civil Hospital, Karachi from November 1, 2003-April 15, 2004.


METHODS
One hundred females, aged 18-35 years, ASA physical status I and II, with singleton pregnancy undergoing elective or emergency cesarean section under spinal anesthesia were randomly allocated to receive spinal anesthesia either by using 25-gauge Quincke or 25-gauge Whitacre needles. Patients were followed for 3 days postoperatively. Headache, its relation with posture, onset, duration, severity and response to the treatment were recorded.


RESULTS
Compared with the Whitacre group, frequency of postdural puncture headache was significantly higher in Quincke group (*p=0.015), while the overall occurrence of non-postdural puncture headache (NPDPH) did not differ significantly between two groups (p=0.736). Most of PDPH developed on 2nd postoperative day, were mild in nature and resolved within 48 hours of their onset. There was no significant difference in the failure rate of spinal anesthesia in both groups (p=0.149).


CONCLUSIONS
It is suggested that use of 25-gauge Whitacre needle reduces the frequency of PDPH without increasing the failure rate of spinal anesthesia in obstetric patients.
Bano
Fauzia
F
Department of Anesthesiology and Surgical ICU, Dow University of Health Sciences and Civil Hospital, Karachi. sanganifauzia@hotmail.com
Haider
Saeeda
S
Aftab
Sadqa
S
Sultan
S Tipu
ST
D000293:Adolescent; D000328:Adult; D000775:Anesthesia, Spinal / Q000009:adverse effects* / Q000295:instrumentation; D002585:Cesarean Section; D005260:Female; D006261:Headache / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D009339:Needles / Q000009:adverse effects*; D016602:Needlestick Injuries / Q000150:complications; D010154:Pakistan; D011247:Pregnancy; D016037:Single-Blind Method; D017211:Treatment Failure