Post dural puncture headache following subarachnoid block for caesarean section: A comparision between 25G and 27G Quincke spinal needle

Abstract

Background Post Dural puncture headache is an iatrogenic complication following subarachnoid block. Fine gauge spinal needle especially 27G though requiring technical expertise to use, probably represents the optimum needle for SAB in respect to frequency and severity of PDPH.

Objective To compare the frequency and severity of post Dural puncture headache in obstetric patients using 25G and 27G Quincke spinal needle.

Methods Forty full term parturient aged between 18-45 years, with ASA physical status I &II underwent elective Caesarean section under SAB were randomly divided into two groups. Anesthetic technique was standardized using 1.5-2.0 ml 0.5% hyperbaric bupivacaine at L3-4 interspace.Frequency and severity of post dural puncture headache (PDPH) were recorded. Data were analyzed using SPSS program.

Results Frequency of PDPH following the use of 25G Quincke (Group I) and 27G Quincke (Group II) spinal needs was 20% (4/20) and 0% (0/20) respectively. All PDPH in Group I was moderate in type and no severe PDPH developed in any Group. Most of the patients with PDPH developed it on 1st and 2ndpostoperative day.

Conclusion: when using a 27G Quincke spinal needle, the frequency and severity of PDPH was significantly lower than when a 25G Quincke spinal needle was used.

JBSA 2012; 25(2): 54-58