Postspinal Headache in Taylor's Approach: A Comparison between 21- and 25-Gauge Needles in Orthopaedic Patients

Abstract

A randomized study was carried out on 160 patients aged 30-60 years with the aim of finding a method of preventing postdural puncture headache (PDPH). In Taylor's lumbosacral approach to the subarachnoid space, two different needle sizes were used (21-gauge versus 25-gauge) for injecting the anaesthetic solution. Our results show an overall incidence of PDPH in nearly 8% of patients, with no significant difference related to the size of the needle employed. Patients with PDPH showed mild symptoms which disappeared in a short time and none needed epidural blood patching. The possibility of using larger needles, facilitating the execution of the block without increasing PDPH incidence, renders this technique particularly attractive in patients where the midline approach is not feasible, or when pencil-point needles are not available.

The association between post‐dural puncture headache and needle type during spinal anaesthesia: a systematic review and network meta‐analysis

“…One study [18] compared two types of cutting needles of the same size, which did not allow us to distinguish the nodes. A second study was the only study to include 21‐G cutting (21C) needles [19] and did not have connections with the network. The resulting 59 studies included 14,961 participants who underwent spinal anaesthesia with one of 11 distinct spinal needles (Fig.…”

Comparison of the Effect of Landmark-Based Midline and Paramedian Approaches on Spinal Anesthesia-Related Complications in Adult Patients: A Meta-Analysis of Randomized Controlled Trials

“…When the needle advances in the paramedian approach, a smaller entry angle is required than in the midline technique, resulting in an oblique needle track on the thick dura mater. This makes the opening site of the dura mater resemble a flap valve that closes [28]. Additionally, the different penetration sites on the dural and arachnoid layers, which do not overlap, produce a second flap valve function [28].…”

“…This makes the opening site of the dura mater resemble a flap valve that closes [28]. Additionally, the different penetration sites on the dural and arachnoid layers, which do not overlap, produce a second flap valve function [28]. Second, a self-blood patching effect was observed through the internal vertebral venous plexus puncture in the epidural space.…”