Spinal needle and post-dural puncture headache

2021 ◽  
Author(s):  
Salvatore Gulizia ◽  
Emanuele D’Amico ◽  
Francesco Patti ◽  
Mario Zappia
Keyword(s):  
Dural Puncture ◽  
Spinal Needle ◽  
Post Dural Puncture Headache

scholarly journals Comparison of the effects of sagittal versus transvers 25-gauge quincke needle insertion on post-dural puncture headache development

2020 ◽  
Vol 7 (7) ◽  
pp. 554-559
Author(s):  
Mehmet Tercan ◽  
Tuğba Bingöl Tanrıverdi ◽  
Gülçin Patmano ◽  
Ahmet Atlas ◽  
Ahmet Kaya ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Dura Mater ◽  
Dural Puncture ◽  
Multivariate Logistic Regression Analysis ◽  
Needle Insertion ◽  
Spinal Needle ◽  
Post Dural Puncture Headache ◽  
Spinal Puncture ◽  
American Society

Objective: Post-dural puncture headache (PDPH) is one of the most important complications after spinal anesthesia. This study aimed to investigate the effect of the sagittal or transverse application of 25-gauge Quincke spinal needle on PDPH development in patients undergoing cesarean section. Material and Methods: A total of 295 patients with a planned cesarean section between the ages of 18-40 years with an American Society of Anesthesiologists score of 1 or 2 were included in the study. For the spinal intervention, 25-gauge Quincke spinal needle was used in all patients. Patients were included in one of two groups according to the spinal needle cutting direction of the dura mater fibers as sagittal (parallel to dura mater fibers, Group S; n=145) or transverse group (perpendicular to dura mater fibers, Group T; n=150). Results: PDPH developed in 27 (9.2%) patients. Patients in Group T had significant higher ratio of PDPH compared to patients in Group S (16% vs. 2.1%, p<0.001). Additionally, patients with PDPH had a significantly higher frequency of ≥2 spinal puncture attempts compared to patients without PDPH (22.2% vs. 4.5%, p=0.003). Multivariate logistic regression analysis demonstrated that transverse needle direction (OR: 11.40, 95% CI: 2.73-34.71; p<0.001) and ≥2 spinal puncture attempts (OR: 9.73, 95% CI: 3.13-41.55; p<0.001) and were independent predictors for PDPH development. Conclusion: Transverse insertion of the 25-gauge Quincke needle into spinal cord fibers and repeated interventions are independently associated with the development of PDPH in cesarean section patients undergoing spinal anesthesia

scholarly journals Comparison of post-dural puncture headache incidence among patients undergoing spinal anaesthesia for elective caesarean section by using quincke 25-G and 29-G spinal needles

2021 ◽  
Vol 9 (9) ◽  
pp. 2588
Author(s):  
Tahreem Omer ◽  
Anum Anwar ◽  
Hina Nabi Ahmed ◽  
Mohammad Harris Khan ◽  
Maaz Barlas ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Dural Puncture ◽  
Standard Dose ◽  
Elective Caesarean Section ◽  
Previous History ◽  
Spinal Needle ◽  
Post Dural Puncture Headache ◽  
Group 2 ◽  
Group 1

Background: Multiple complications including hypotension, nausea, vomiting, urinary retention, transient neurological symptoms and headache have been associated with spinal anaesthesia. Importantly, post dural puncture headache (PDPH) varies with the type and size of spinal needle employed for inducing anaesthesia. Here, we aimed to compare the frequency of PDPH in patients underwent spinal anaesthesia for elective caesarean section using 25-gauge (G) and 29-G Quincke spinal needle.Methods: We designed a randomized control trial at Obstetrics and Gynecology Operation Theatres, Jinnah Hospital, Lahore. A total of 152 patients having age 30.28±8.21 years were enrolled in the study and divided into two groups each comprising of 76 patients. In group 1, spinal anaesthesia was performed using 25-G Quincke spinal needle while in group 2 spinal anaesthesia was administered employing 29-G Quincke spinal needle. A standard dose of 10.5-12.0 mg (1.4-1.6 ml) of 0.75% bupivacaine is infiltrated in subarachnoid space at lumber region L3-L4 or L4-L5 following aseptic measures. The patients were evaluated for PDPH during the follow up period.Results: The previous history of PDPH was observed in 20.39% patients. The comparative study showed that the PDPH was observed in 12 (15.7%) patients in group 1 while the group 2 revealed PDPH in only 2 (2.6%) patients.Conclusions: Thus 29-G spinal needle can be regarded as a better option to reduce PDPH in patients subjected to spinal anaesthesia for elective cesarean in contrast to the use of 25-G Quincke spinal needle.

scholarly journals Comparative Study between 25 Gauge Spinal Needle (Quincke) versus (pencil point) As Regarding incidence of Post Dural Puncture Headache

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
F S L Eskander ◽  
D A Ibrahim ◽  
A H Hamza ◽  
M G Mahmoud
Keyword(s):  
Dural Puncture ◽  
Incidence Rates ◽  
Daily Activities ◽  
Spinal Needle ◽  
Inclusion Criteria ◽  
Post Dural Puncture Headache ◽  
Point Versus ◽  
Group A ◽  
Different Shapes ◽  
Group B

Abstract Background PDPH can affect patients’ functional recovery and comfort, both are critical factors for patients who expect to resume their daily activities as soon as possible. Especially obstetric patients who will be responsible for a new child. Objective The aim of this study is to assess the incidence of PDPH by using the same 25gauge spinal needle but with two different shapes pencil point versus quincke. Patients and Methods The study was conducted on 60 randomly chosen patients full filling inclusion criteria in Matarya teaching hospital after approval of the medical ethical committee. They were allocated in two groups of 30 patients each: Group(A) 25 gauge spinal needle (quincke) is used. Group (B) 25 gauge spinal needle (pencil point)is used. The two groups were adequately monitored and assessed intra- and post-operatively and they were compared in vital data as regarding HR, SBP, DBP and the development of PDPH, if developed classified into mild, moderate and severe and assessment of backache. Results The results of this study revealed that patients in the study group(A) had more incidence of PDPH 10% compared to 0% in group (B) although still no significant statistical deference but still non beveled spinal needle have lower rates of incidence than quincke (beveled ) spinal needles. Also we found 5 patients out of 30 (16.7%) suffered from backache in group A and one patient (3.3%) suffered from mild backache in group B. Conclusion Our study suggests that the use of non beveled spinal needles lead to less incidence rates of PDPH. The frequency and severity of PDPH was higher in 25G cutting spinal(quincke) needle group as compared to non cutting (pencil point)needle. For spinal anesthesia.

scholarly journals Incidence of Postdural Puncture Headache after Caesarean Section Comparison Between 25G and 27G Quincke Variety of Spinal Needle

KYAMC Journal ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. 762-769
Author(s):  
Md Afzalur Rahman ◽  
ABM Muksudul Alam ◽  
Muhammad Alamgir Mandal ◽  
Mostofa Kamruzzaman ◽  
Md Asraful Kabir ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Dural Puncture ◽  
Epidural Blood Patch ◽  
Spinal Needle ◽  
Postdural Puncture Headache ◽  
Post Dural Puncture Headache ◽  
Group I ◽  
Blood Patch ◽  
Group Ii

Background: Post dural puncture headache is related to the size as well as type of the spinal needle used90. It is progressively reduced with the use of thinner Quincke type spinal needles.Objective: This was a Quasi-experimental study to compare the incidence of post dural puncture headache after caesarian section with spinal anaesthesia by two typys of needles named 25G and 27G Quincke varities.Methods: This study was conducted in the Department of Anaesthesiology of Shaheed Shurawardy Medical College Hospital, Dhaka. A total number of 60 adult patients with ASA physical status I & II scheduled for elective surgical caesarian section under spinal anaesthesia were enrolled in this study. Patients were randomly allocated equally, 30 in each group into two groups I and II. Patients of Group I, II received 25G and 27G quincke variety of spinal needle respectively. The randomization was double blind except for the anaesthetist performing spinal block. Patient, surgeon and the assessor in the ward was aware of the study. Spinal anaesthesia was performed with 2.0-2.5 ml 0.5% hyperbaric bupivacaine using 25G Quincke spinal needle (Group I),and 27G Quincke spinal needle (Group II) at L3-4 inter-vertebral space. Each patient was assessed daily for four consecutive days following Caesarean section. Incidence and severity of postdural puncture headache (PDPH) was recorded.Result: Seven (7) out of 60 patients developed PDPH giving an overall frequency of 11.6% (Table-2). Frequency of PDPH was 16.7% (5/30) in Group I, 6.7% (2/30) in Group II. In Group I, PDPH was mild in 3 patients (60%), moderate in 1 patient (20%) and severe in 1 patient (20%). In Group II, it was mild in 2 (100%), moderate in 0 and severe in 0 patient. Moderate and Severe PDPH was not observed with 27G Quincke spinal needle (Group II). None of the 60 patients with PDPH required an epidural blood patch. Symptoms were relieved by conventional means in all patients.Conclusion: In current practice epidural blood patch has the highest cure rate for management of PDPH and is usually very well tolerated by majority of patients. Overall, we concluded that when performing spinal anaesthesia for Caesarean section, 27G Quincke spinal needle has definite advantage over 25G Quincke spinal needles as far as frequency and severity of PDPH is concerned. Therefore we recommend routine use of the 27G Quincke spinal needle when performing spinal anaesthesia for Caesarean section.KYAMC Journal Vol. 7, No.-2, Jan 2017, Page 762-769

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