A comparative study of 27 G Quincke and Whitacre spinal needle for evaluation of postdural puncture headache

Abstract

Background: Postdural puncture headache (PDPH) is a well-known complication of spinal anaesthesia. Two strategies have evolved to reduce the incidence of PDPH: First, to reduce the gauge of needle and second, to change the design of needle tip. Needle size might be the most significant factor in the development of PDPH. Aim: To compare the incidence of post-dural puncture headache and technical difficulties in lower abdomen surgeries under subarachnoid block between 27-G Whitacre spinal needle and 27-G Quincke spinal needle. Materials and Method: The present study was conducted at Tertiary Care Hospital and patients who were posted for lower abdomen surgeries including caesarean section, pelvis/perineum and lower limb surgeries under subarachnoid block and ASA physical status I and II were included in the study. A study proforma was formulated and details of demographic characteristics, baseline vitals, failure to produce spinal anaesthesia, time in seconds to the first appearance of cerebrospinal fluid (CSF) at the hub of the spinal needle, number of attempts to obtain CSF intraoperatively and patients were interviewed postoperatively. Results: The mean duration PDPH in the study was 33.84±25.14 hours in Quincke group as compare to 21±10.52 hours in Whitacre group and appearance of no significant difference between groups. Duration of headache lasted <24 hours and 24-48 hours (6 vs 3 & 4 vs 1 patient) among Quincke and Whitacre group respectively. Conclusion: The use of a 27-G Whitacre spinal needle was associated with a significantly lower incidence of PDPH than a 27-G Quincke spinal needle used for spinal anaesthesia. Key Word:27 G Quincke and Whitacre spinal needle *Address for Correspondence: Dr.Anshu S. S. Kotia, Assistant Professor, Department of Anaesthesiology, Jaipur National University Institute for Medical Sciences and Research Centre, Jagatpura, Jaipur, INDIA. Email:health@jnuhealthcare.com Received Date: 03/06/2019 Revised Date: 30/06/2019 Accepted Date: 07/08/2019 DOI: https://doi.org/10.26611/1015111212