Comparison of 26G Quincke versus Whitacre Needles for Post Dural Puncture Headache in Obstetric Patients
Bhairavi T.G.1, Vidhya N.2, Ajay Kumar A.3
1Junior Resident 2Assistant Professor 3Professor, Department of Anaesthesia, Sree Balaji Medical College, CLC Works Road, Chromepet, Chennai, Tamil Nadu 600073, India.
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Introduction: Caesarean section under sub arachnoid block is practiced worldwide due to its advantages over generalanaesthesia. The greatest drawback is PDPH.The incidence of PDPH can be decreased by decreasing the size of the spinal needle, or by using pencil point needles, which separate rather than cut through the dural fibers. Materials and methods: 60 consecutive women of ASA I and II, aged 18- 35years, with uncomplicated pregnancy undergoing caesarian section under spinal anesthesia were recruited. They were randomly allocated to two groups of 30 patients each. Patients in group I received spinal anesthesia using 26G Quincke spinal needles and in patients of group II, 26G Whitacre needleswere used. Patients were followed up for 7 days. Observations: The incidence of PDPH was 20% in group I and 3% in group II. This difference in incidence was statistically significant (p value 0.011). In group II, 1 patient developed mild PDPH on the second postoperative day, which resolved on the 4th postop day. In group I, 6 patients developed mild PDPH on the 2nd postop day. The headache remained mild and resolved on the 4th postop day in 3 patients. Of the remaining 3 patients, 2 developed moderate headache and 1 developed severe headache on the 3rd postop day. Headache resolved on the 5th day in these 3 patients. There was a statistically significant difference in the severity of PDPH. Conclusion: The incidence of PDPH was significantly lower with 26GWhitacre needle (pencil point) when compared with 26GQuincke needle.
Corresponding Author : Vidhya N., Assistant Professor, Department of Anaesthesia, Sree Balaji Medical College, CLC Works Road, Chromepet, Chennai, Tamil Nadu 600073, India.