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Comparison of Post Dural Puncture Headache with 23G, 25G and 27G quincke needle in Caesarean section
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Why is it important?
Background: Post dural puncture headache (PDPH) is a common and incapacitating complication of spinal anesthesia, with higher incidence in obstetric patients, affects postoperative wellbeing of mother as well as child. The study was undertaken to compare incidence and severity of post dural puncture headache in caesarean section after spinal anesthesia using 23G, 25G and 27G quincke needle. Methodology: 150 patients of ASA grade I or II undergoing emergency or elective caesarean section were selected and randomly divided in to 3 equal (50 in each) groups; A, B and C and received spinal anesthesia with 23G, 25G and 27G spinal needle respectively. No. of trials, time to get successful puncture and time to achieve T6 block recorded. Incidence, onset, severity and duration of PDPH recorded postoperatively. Results: Incidence of PDPH was 20%, 6% and 0% in group A, B and C respectively. Onset and duration of PDPH were 34.60 (+ 4.427) hrs and 5.90 (+ 0.876) days in group A and 39.33 (+ 3.055) hrs and 4.67 (+0.577) days in group B respectively. 2 patients in group A had moderate and rest had mild PDPH. 6 patients in group A, 10 patients in group B and 14 patients in group C required >1 trial. Time taken for successful puncture was 21.8 (+9.833), 44.08 (+14.251) and 92.72 (+12.420) sec in groups A, B and C respectively. Time to achieve T6 level was 4.08 (+1.226), 6.22 (+1.112) and 7.14 (+1.16) min in group A, B and C respectively. Conclusion: Incidence of PDPH was significantly lower with 27G and 25G than in 23G spinal needles.
Perspectives
Background: Post dural puncture headache (PDPH) is a common and incapacitating complication of spinal anesthesia, with higher incidence in obstetric patients, affects postoperative wellbeing of mother as well as child. The study was undertaken to compare incidence and severity of post dural puncture headache in caesarean section after spinal anesthesia using 23G, 25G and 27G quincke needle. Methodology: 150 patients of ASA grade I or II undergoing emergency or elective caesarean section were selected and randomly divided in to 3 equal (50 in each) groups; A, B and C and received spinal anesthesia with 23G, 25G and 27G spinal needle respectively. No. of trials, time to get successful puncture and time to achieve T6 block recorded. Incidence, onset, severity and duration of PDPH recorded postoperatively. Results: Incidence of PDPH was 20%, 6% and 0% in group A, B and C respectively. Onset and duration of PDPH were 34.60 (+ 4.427) hrs and 5.90 (+ 0.876) days in group A and 39.33 (+ 3.055) hrs and 4.67 (+0.577) days in group B respectively. 2 patients in group A had moderate and rest had mild PDPH. 6 patients in group A, 10 patients in group B and 14 patients in group C required >1 trial. Time taken for successful puncture was 21.8 (+9.833), 44.08 (+14.251) and 92.72 (+12.420) sec in groups A, B and C respectively. Time to achieve T6 level was 4.08 (+1.226), 6.22 (+1.112) and 7.14 (+1.16) min in group A, B and C respectively. Conclusion: Incidence of PDPH was significantly lower with 27G and 25G than in 23G spinal needles.
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This page is a summary of: Comparison of Post Dural Puncture Headache with 23G, 25G and 27G quincke needle in Caesarean section, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6219.31.
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