Do pencil-point spinal needles decrease the incidence of postdural puncture headache in reality? A comparative study between pencil-point 25G Whitacre and cutting-beveled 25G Quincke spinal needles in 320 obstetric patients

Abstract

Background:Postdural puncture headache (PDPH) is a distressing complication of the subarachnoid block. The previous studies conducted, including the recent ones, do not conclusively prove that pencil-point spinal needles decrease the incidence of PDPH. In this study, we have tried to find out whether a pencil-point Whitacre needle is a better alternative than the classic cutting beveled, commonly used, Quincke spinal needle, in patients at risk of PDPH.Materials and Methods:Three hundred and twenty obstetric patients, 20-36 years of age, ASA I and II, posted for Cesarean section under subarachnoid block, were randomly assigned into two groups W and Q, where 25G Whitacre and 25G Quincke spinal needles were used, respectively. The primary objective of the study was to find out the difference in incidence of PDPH, if any, between the two groups, by using the t test and Chi square test.Results:The incidence of PDPH was 5% in group W and 28.12% in group Q, and the difference in incidence was statistically significant (P<0.001).Conclusion:The pencil-point 25G Whitacre spinal needle causes less incidence of PDPH compared to the classic 25G Quincke needle, and is recommended for use in patients at risk of PDPH.

Do Anaesthesiologists Prefer Whitacre Needle Over Quincke for Lumbar Subarachnoid Block? An Analytical Study

“…Although it has been in practice for a long time, newer varieties of needles are in use now a days with which incidence of adverse effects have drastically come down. 9 These new needles have revolutionised the techniques of the procedure because of which the success rate of the procedure has also improved. 9,10 Most Anaesthesiologists are familiar with Quincke needle which is commonly available in many of the hospitals.…”

“…9 These new needles have revolutionised the techniques of the procedure because of which the success rate of the procedure has also improved. 9,10 Most Anaesthesiologists are familiar with Quincke needle which is commonly available in many of the hospitals. In spite of the better features of newer needles like Whitacre, Quincke is possibly the preferred needle due to its easy availability and lesser cost.…”

“…In spite of the better features of newer needles like Whitacre, Quincke is possibly the preferred needle due to its easy availability and lesser cost. 9 LSAB is a blind procedure which solely depends on the give way feel experienced by the anaesthesiologist to the advancing needle. 11 Hence, a successful LSAB will require a perception of give way to resistance offered by the tissues juxtapositioned between the skin and the arachnoid matter.…”

Impact of spinal needle type on postdural puncture headache among women undergoing Cesarean section surgery under spinal anesthesia: A meta‐analysis

“…Clear definition is not provided Pal (2011) Headache experienced in the frontal or occipital region exacerbated by sitting or standing position and reduced or relieved by lying down and may be accompanied by nausea, vomiting, neck stiffness, diplopia, and tinnitus.…”

“…Nine studies (11 comparisons, 1313 participants) reported the failure of spinal anesthesia. 14,16,17,22,39,43,[45][46][47] There was no statistically significant difference of the pooled incidence of failure of spinal anesthesia between the pencil-point SN and the cutting-bevel SN (RR = 1.28, 95% CI 0.56 to 2.93; P = 0. 55, I 2 = 0%).…”