Postdural puncture headache incidence with 25G and 27G Quincke needles after spinal anesthesia for elective cesarean section

Abstract

Background: Post dural puncture headache(PDPH) is a bilateral occipito-frontal headache occurs in 0.1 to 36% of cases receiving spinal anesthesia. We evaluated the incidence of PDPH after spinal anesthesia using two commonly used needles, 25G and 27G Quincke needles among females undergoing elective cesarean section. Aims and Objectives: The aim of the study was to compare the post-dural puncture headache with 25G And 27G Quincke Needle – in terms of Incidence, severity in patients after spinal anesthesia for elective caesarean section and to find out number of attempts for successful block and any associated complications. Materials and Methods: Six hundred females of ASA grade I or II posted for elective cesarean section under spinal anesthesia were enrolled into two equal groups to assess incidence of PDPH in the post-operative period. They were assessed by a blinded observer for the onset of headache, characteristics, duration, severity, and any associated symptoms for 5 days. PDPH was defined as postural headache that was aggravated by sitting or standing position and relieved by lying supine. Results: The incidence of PDPH was 11% in 25G needle group and 6.33% in the 27G needle group [Risk Ratio of 0.58 (95% CI: 0.34, 0.99)]. In none of the groups, intensity of headache was severe while all were mild in the 27G group. Nausea and vomiting were the only associated symptomatology, 7.33% in the 25G group and 5.67% in the 27G group. Conclusion: The results support 27G Quincke needle to administer spinal anesthesia in females undergoing elective cesarean section.

Postdural Puncture Headache after Spinal Anaesthesia in Parturients Undergoing Cesarean Section in the Department of Anesthesia in a Tertiary Care Center: A Descriptive Cross-sectional Study

“…Our findings are similar to the past study conducted in a similar setting using a 25 G Quincke needle. 11 These patients were managed conservatively with their ongoing pain medication, hydration, and bed rest.…”

Effect of Patient Position during Spinal Anesthesia on the Incidence of Post-Dural Puncture Headache after Cesarean Section

“…In addition to these factors, the posture of patient during the dural puncture plays an important part in influencing the incidence of post-dural puncture headache. [16][17][18] Generally, the spinal anesthesia can be administered among patients in either sitting position or lateral position. 19 The lateral decubitus position has emerged as an interesting approach that helps in reducing the risk of PDPH because of its feasibility as well as patient satisfaction.…”