title: Do pencil-point spinal needles decrease the incidence of postdural puncture headache in reality? A comparative study between pencil-point 25G Whitacre and cutting-beveled 25G Quincke spinal needles in 320 obstetric patients.
abstract: BACKGROUND
  Postdural puncture headache (PDPH) is a distressing complication of the subarachnoid block. The previous studies conducted, including the recent ones, do not conclusively prove that pencil-point spinal needles decrease the incidence of PDPH. In this study, we have tried to find out whether a pencil-point Whitacre needle is a better alternative than the classic cutting beveled, commonly used, Quincke spinal needle, in patients at risk of PDPH.
  
  
  METHODS
  Three hundred and twenty obstetric patients, 20-36 years of age, ASA I and II, posted for Cesarean section under subarachnoid block, were randomly assigned into two groups W and Q, where 25G Whitacre and 25G Quincke spinal needles were used, respectively. The primary objective of the study was to find out the difference in incidence of PDPH, if any, between the two groups, by using the t test and Chi square test.
  
  
  RESULTS
  The incidence of PDPH was 5% in group W and 28.12% in group Q, and the difference in incidence was statistically significant (P<0.001).
  
  
  CONCLUSIONS
  The pencil-point 25G Whitacre spinal needle causes less incidence of PDPH compared to the classic 25G Quincke needle, and is recommended for use in patients at risk of PDPH.
authors.affiliation: Department of Anesthesiology, Calcutta National Medical College (CNMC), Kolkata, India.
authors.forename: Anirban
authors.initials: A
authors.lastname: Pal
authors.affiliation: Department of Anesthesiology, Bangur Institute of Neurology(BIN), Kolkata, India.
authors.forename: Amita
authors.initials: A
authors.lastname: Acharya
authors.affiliation: Specialist Medical Officer (Anesthesiology), West Bengal Health Service, West Bengal, India.
authors.forename: Nidhi Dawar
authors.initials: ND
authors.lastname: Pal
authors.affiliation: Department of Anesthesiology, Calcutta National Medical College (CNMC), Kolkata, India.
authors.forename: Satrajit
authors.initials: S
authors.lastname: Dawn
authors.affiliation: Department of Gynaecology and Obstetrics, Institute of Post-Graduation Medical Education and Research (IPGME and R), Kolkata, India.
authors.forename: Jhuma
authors.initials: J
authors.lastname: Biswas
keywords: Cesarean section; Quincke spinal needle; Whitacre spinal needle; postdural puncture headache; subarachnoid block