title: Post dural puncture headache after spinal anaesthesia for caesarean section: a comparison of 25 g Quincke, 27 g Quincke and 27 g Whitacre spinal needles.
abstract: OBJECTIVE
  To compare the frequency and severity of post dural puncture headache in obstetric patients using 25G Quincke, 27G Quincke and 27G Whitacre spinal needles.
  
  
  METHODS
  Comparative, randomized, double-blind, interventional study.
  
  
  METHODS
  Liaquat University Hospital Hyderabad from October 2005 to December 2006.
  
  
  METHODS
  480 ASA I-II full term pregnant women, 18 to 45 years of age, scheduled for elective Caesarean section, under spinal anaesthesia, were randomized into three groups: Group I (25G Quincke spinal needle: n=168), Group II (27G Quincke spinal needle: n=160) and Group III (27G Whitacre spinal needle: n=152). Spinal anaesthesia was performed with 1.5-2.0 ml 0.75% hyperbaric bupivacaine using 25G Quincke spinal needle (Group I), 27G Quincke spinal needle (Group II) and 27G Whitacre spinal needle (Group III) at L3-4 inter-vertebral space. Each patient was assessed daily for four consecutive days following Caesarean section. Frequency and severity and of postdural puncture headache (PDPH) were recorded. Data were analyzed using SPSS-11.
  
  
  RESULTS
  Frequency of PDPH following the use of 25G Quincke (Group I), 27G Quincke (Group II) and 27G Whitacre (Group III) spinal needles was 8.3% (14/168), 3.8% (6/160) and 2.0% (3/152) respectively. In Group I, PDPH was mild in 5 patients, moderate in 7 patients and severe in 2 patients. In Group II, it was mild in 2, moderate in 3 and severe in 1 patient. In group III, it was mild in 2 and moderate in 1 patient. Severe PDPH did not occur in Group III. Most of the patients with PDPH developed it on 1st and 2nd postoperative day.
  
  
  CONCLUSIONS
  When using a 27G Whitacre spinal needle, the frequency and severity of PDPH was significantly lower than when a 25G Quincke or 27G Quincke needle was used.
authors.affiliation: Department of Anaesthesiology & Intensive Care, Liaquat University of Medical & Health Sciences, Jamshoro, Sindh, Pakistan. dr_janmohammad@hotmail.com
authors.forename: Jan Muhammad
authors.initials: JM
authors.lastname: Shaikh
authors.forename: Amna
authors.initials: A
authors.lastname: Memon
authors.forename: Muhammad Ali
authors.initials: MA
authors.lastname: Memon
authors.forename: Majida
authors.initials: M
authors.lastname: Khan
mesh_terms: D000293:Adolescent; D000328:Adult; D000773:Anesthesia, Obstetrical / Q000295:instrumentation*; D000775:Anesthesia, Spinal / Q000295:instrumentation*; D002585:Cesarean Section; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008875:Middle Aged; D009339:Needles; D010154:Pakistan / Q000453:epidemiology; D051299:Post-Dural Puncture Headache / Q000453:epidemiology*; D011247:Pregnancy