Post-dural puncture headache in young adults: comparison of two small-gauge spinal catheters with different needle design.
BACKGROUND
To reduce the risk of post-dural puncture headache (PDPH) in continuous spinal anaesthesia, small-gauge spinal catheter systems with different techniques of dural perforation have been developed.


METHODS
Two systems, the catheter through-needle technique (MicroCatheter, Portex, UK) and the catheter over-needle technique (22G Spinocath, B. Braun, Germany), were used in 18 young healthy volunteers (age 18-30 yr), who were enrolled in a neuroendocrinological investigation for analysis of neuropeptides in cerebrospinal fluid (CSF). After intermittent sampling of CSF (17 x 0.5 ml over 4 h), the catheter was removed and the development of PDPH and pain intensity were documented prospectively by the subjects in a standardized headache assessment (11-point numerical rating scale [NRS]).


RESULTS
The study revealed a high overall incidence of PDPH (78%) with no significant differences between groups (P=0.26). However, the over-needle group showed a significantly shorter duration of PDPH (2.4 [SD 2.3] vs 5.1 [3.1] days, P=0.050) and lower maximum pain intensity (3.1 [2.9] vs 7.3 [3.4] NRS, P=0.014) than the through-needle group.


CONCLUSIONS
The results demonstrate a potential benefit of the catheter over-needle technique for the reduction of the duration and intensity of PDPH.
Gosch
U W
UW
Department of Anaesthesiology, University of Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany. u-gosch@foni.net
Hueppe
M
M
Hallschmid
M
M
Born
J
J
Schmucker
P
P
Meier
T
T
D000293:Adolescent; D000328:Adult; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D000886:Anthropometry; D004388:Dura Mater / Q000293:injuries*; D004867:Equipment Design; D005260:Female; D006261:Headache / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D009339:Needles; D009479:Neuropeptides / Q000134:cerebrospinal fluid; D010147:Pain Measurement; D011446:Prospective Studies; D013129:Spinal Puncture / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods
D009479:Neuropeptides