Incidence of post-dural puncture headache: A comparison of quinckes' versus whitacres' spinal needles

Abstract

Background: Repeated attempts at insertion, block failure, and post-dural puncture headache are the most common drawbacks of spinal anesthesia. This study was designed to re-evaluate these untoward effects of subarachnoid block. The primary aim of the study is to compare the incidence of post-dural puncture headache with 25-gauge Quincke's and Whitacre's spinal needles. The secondary objectives include assessing the difference in attempt rate and failure rate during subarachnoid block. Materials and Methods: In this randomized prospective study, 100 American Society of Anesthesiologists physical status I and II adult patients of both sex undergoing surgery below umbilicus under subarachnoid block were assigned in to two equal groups of 50 each; they were to receive spinal anesthesia either with Quincke's (group QC) or Whitacre's (group WP) spinal needles. The incidence of post-dural puncture headache, number of attempts required for successful insertion, and frequency of failed subarachnoid block were recorded. Data obtained were analyzed using t-test and Chi-square test. A value of P < 0.05 was deemed as statistically significant. Results: All the 100 patients completed the study. Significantly high rate (P = 0.009) of post-dural puncture headache was recorded in Quincke group (18%) as compared to Whitacre group (2%). In addition, the number of attempts required were less with Whitacre's needle; however, no statically significant association between the type of the needle, attempt rate, and failure rate during spinal anesthesia could be detected (P = 0.2425). Conclusion: Overall to reduce the number of attempts and the incidence of post-dural puncture headache, Whitacre's 25-gauge spinal needle has better option than Quincke's 25-gauge spinal needle for subarachnoid block.