The incidence of post dural puncture headache after spinal anaesthesia for caesarean section with a pencilpoint needle whitacre 25 gauge

1994 ◽  
Vol 3 (2) ◽  
pp. 116
Author(s):  
R. Helsted ◽  
B.D. Pedersen
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Dural Puncture ◽  
Post Dural Puncture Headache

scholarly journals To Compare the Incidence of Post-Dural Puncture Headache Using 25G Quincke and 25G Whitacre Spinal Needles in Patients Undergoing Lower Segment Caesarean Section

2021 ◽  
Vol 10 (14) ◽  
pp. 1014-1019
Author(s):  
Aditya Rameshbabu Devalla ◽  
Sanjot S. Ninave ◽  
Amol P. Singam
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Dural Puncture ◽  
Lower Segment ◽  
Early Ambulation ◽  
Post Dural Puncture Headache ◽  
Lower Segment Caesarean Section ◽  
Key Words Spinal Anaesthesia ◽  
American Society ◽  
Obstetric Surgery

BACKGROUND Spinal anaesthesia is the first preference of anaesthesia in obstetric surgery. Post dural puncture headache (PDPH) is more common after C-section in young parturients. In the present world which is developing and fast-paced, brisk recovery along with minimal side effects & importantly early ambulation are now the need of the hour. This headache is more worrying to the mother who is required to tend to the newborn baby. This study compared the incidence of PDPH subsequent to subarachnoid blockade for lower segment Caesarean section (LSCS) 25G Whitacre & 25G Quincke needles. We wanted to compare the incidence of PDPH using 25G Quincke and 25G Whitacre spinal needles in patients undergoing LSCS. METHODS Two hundred (ASA II) American Society of Anaesthesiologists 11 females who were pregnant and in the age group of 20 - 50 years, planned to get sub-arachnoid blockade for C-section, were assigned randomly into two equal groups (N = 100 each). Both groups received spinal anaesthesia with 25-gauge Quincke and 25 gauge Whitacre needle. Postoperatively, incidence, site, onset, severity and duration of headache was studied. RESULTS The incidence of post spinal headache was 6 % in the Quincke group. No patients in Whitacre group had PDPH. The number of lumbar punctures required for successful sub arachnoid block was recorded in both the groups. 92 % patients from group Q and 88 % patients from group W required only one puncture. 8 % patients from group Q and 12 % patients from group W required two punctures. CONCLUSIONS It is prudent to conclude that 25G Whitacre spinal needle is a better alternative to 25G Quincke needle for reducing the incidence of post dural puncture headache in patients undergoing lower segment Caesarean section. KEY WORDS Spinal Anaesthesia, Post Dural Puncture Headache, Caesarean Section

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 Effect of Hydrocortisone on Reducing severity of Post Dural Puncture Headache after Spinal Anesthesia for Elective Caesarean Section

2018 ◽  
Vol 23 (4) ◽  
pp. 468-472
Author(s):  
Shumaila Ashfaq ◽  
Liaqat Ali ◽  
Muhammad Ashraf Zia ◽  
Rizwan Ahmad Khan ◽  
Mehtash Butt
Keyword(s):  
Caesarean Section ◽  
Spinal Anesthesia ◽  
Spinal Anaesthesia ◽  
Conventional Treatment ◽  
Dural Puncture ◽  
Elective Caesarean Section ◽  
Tertiary Care ◽  
Post Dural Puncture Headache ◽  
Group A ◽  
Group B

Spinal anesthesia is frequently used in pregnant female undergoing caesarean section due to its safety than general anaesthesia. Post dural puncture headache (PDPH) is commonly occurring problem associated with spinal anaesthesia and causes a considerable morbidity. PDPH depends on several factor and various methods have been used to reduce and treat the pain of PDPH. We evaluated effects of hydrocortisone on the treatment of PDPH in obstetrical patient. To compare mean decrease in Visual Analogue Scalepain score in patients who developed PDPH after elective caesarean section under spinal anaesthesia who were given conventional treatment versus conventional treatment plus hydrocortisone. Double blind randomized control trial. Study conducted in department of anaesthesia and obstetrics of Allama Iqbal Medical College, Jinnah hospital (tertiary care) conducted from13th June 2014 to 13th December 2014. Sample size was calculated 60 (30 each) cases using 95% confidence interval, 80% power of test. Patients who developed PDPH after spinal anaesthesia for elective caesarean section were divided into 2 group; Group A (Conventional Treatment) and Group B, (Conventional Treatment plus Hydrocortisone 100mg 8 hourly for 48 hours). Details were recorded regarding age; mean pretreatment and post treatment VAS after 6 hours. Mean decrease in pain VAS score was 3.30 + 1.2 in group A while 7.17+ 1.3 in group B. (P value 0.001). Intravenous hydrocortisone is more effective in reducing post dural puncture headache pain severity after spinal anaesthesia for elective caesarean section when given along with conventional treatment as compared to conventional treatment alone.

scholarly journals COMPARISON OF OCCURRENCE OF POST DURAL PUNCTURE HEADACHE IN LOWER SEGMENT CAESAREAN SECTION UNDER SUBARACHNOID BLOCK BY MEDIAN VS PARAMEDIAN APPROACH: A RANDOMIZED INTERVENTIONAL STUDY

2021 ◽  
Vol 9 (01) ◽  
pp. 551-558
Author(s):  
Suman K. Dabi ◽  
◽  
Vandana Mangal ◽  
Keyword(s):  
Side Effects ◽  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Dural Puncture ◽  
Lower Segment ◽  
Time Duration ◽  
Post Dural Puncture Headache ◽  
Lower Segment Caesarean Section ◽  
The Difference ◽  
Mean Time

Aims: Spinal anaesthesia is a standard anesthetic technique in obstetrics, as it provides good analgesia and muscle relaxation. But every procedure comes with certain side effects and complications. Lumbar puncture for subarachnoid block is done by either median or paramedian approach. Besides postoperative headache, other side effects like nausea, vomiting have been reported in the postoperative period. Hereby we conducted a study on patients undergoing lower segment caesarean section (LSCS) under spinal anaesthesia by either median or paramedian approach, and compared the occurrence of post dural puncture headache in both groups. Methods and Material: 400 parturients of ASA grade I & II who underwent LSCS under spinal anaesthesia were divided into two groups: Group M (n=200) received spinal block by median approach while Group PM (n=200) received by paramedian approach. We observed the difference in proportion of cases who develop post dural puncture headache (PDPH) in both study groups and also to determine the difference in mean time duration of development of PDPH in both groups. Statistical analysis used:The data was analysed by using chi-square and T-test where p<0.05 was considered as statistically significant Results: 5 patients (2.5%) in group M developed PDPH whereas only 1 patient(0.5%) in group PM developed PDPH which was statistically non-significant (p=0.099). The mean time duration of onset of PDPH was similar in both groups. Conclusions:Hence from our observations we conclude that there is no statistically significant difference in the incidence of occurrence of PDPH when lumbar puncture is done with 25 G by either median or paramedian approach.

scholarly journals Post Dural Puncture Headache following Spinal Anaesthesia for Caesarean Section

2012 ◽  
Vol 6 (2) ◽  
pp. 60-61
Author(s):  
EC Karkada
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Dural Puncture ◽  
Post Dural Puncture Headache

NJOG 2011 Nov-Dec; 6 (2): 60-61 DOI: http://dx.doi.org/10.3126/njog.v6i2.6763

scholarly journals Comparison of 27 G Quincke and 25 G Quincke Needles for Post Dural Puncture Headache in Caesarean Section

2016 ◽  
Vol 12 (1) ◽  
pp. 17-21
Author(s):  
Md Anisul Islam ◽  
Amena Begum ◽  
SM Shahida
Keyword(s):  
Caesarean Section ◽  
Failure Rate ◽  
Spinal Anaesthesia ◽  
Dural Puncture ◽  
Intraoperative Complications ◽  
Armed Forces ◽  
Post Dural Puncture Headache ◽  
Uncomplicated Pregnancy ◽  
Significant Difference ◽  
Group B

Introduction: Although modern anaesthesiology has made great progress in the last decades and spinal anaesthesia is popular for its effectiveness, Post Dural Puncture Headache (PDPH) is a significant and well known complication of spinal anaesthesia that may be incapacitating for patients. A few decades ago less refined and thicker spinal needles were being used and the incidence of PDPH was high. But within the last 15 years more refined and thinner needles have been used and the incidence of PDPH is grossly reduced. Objective: To compare the incidence and severity of post dural puncture headache using 25 G Quincke and 27 G Quincke needle during spinal anaesthesia in case of caesarean section. Materials and Methods: This randomized prospective study was carried out in the Border Guard Hospital, Dhaka, during the period of January to July, 2015. Patients were selected randomly from the age group of 20-35 years having a pregnancy of at least 34 weeks gestation with a single uncompromised fetus and uncomplicated pregnancy. Patients with a history of migraine, convulsion, cerebrovascular accident, Pre-eclampsia, eclampsia, spinal deformity, coagulopathy or previous neurological disease were excluded. They were randomly allocated into two groups. Each group consisting of 50 patients. Data was collected by interviewing and observation results. Data were processed and analyzed by using statistical test. Results: There was no statistically significant difference found in age, height, weight and ASA status between two groups. 27G Quincke needle had significantly higher failure rate of successful lumber puncture in first attempt than the 25G Quincke needle (20% vs 6%, P<0.05). There was no difference difference regarding the incidence of intraoperative complications between two groups. The overall incidence of PDPH was 2(4%) in group A and 12 (24%) in group B (P<0.05). Decreased severity of headache was noted in the 27G group Quincke needle. There was no difference regarding the duration of headache in between two groups. Conclusion: This study suggests that the risk of PDPH was much lower in 27G Quincke needle as compared to 25G Quincke needle though it had a higher failure rate of successful lumber puncture in first attempt. For spinal anaesthesia 27G Quincke needle should be used. Journal of Armed Forces Medical College Bangladesh Vol.12(1) 2016: 17-21

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

scholarly journals The Sprotte Needle and Post Dural Puncture Headache following Caesarean Section

1993 ◽  
Vol 21 (3) ◽  
pp. 280-283 ◽  
Author(s):  
A. W. Ross ◽  
C. Greenhalgh ◽  
D. P. McGlade ◽  
I. G. Balson ◽  
S. C. Chester ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Population Size ◽  
Lower Incidence ◽  
Dural Puncture ◽  
Operating Conditions ◽  
Hyperbaric Bupivacaine ◽  
Post Dural Puncture Headache ◽  
The Difference ◽  
Obstetric Population

One hundred and forty-four patients receiving subarachnoid anaesthesia for caesarean section were prospectively analysed for quality of anaesthesia and the occurrence of post dural puncture headache (PDPH). Anaesthesia was administered via 24 gauge Sprotte (n = 104) and 26 gauge Quincke (n = 40) needles using hyperbaric bupivacaine 0.5% with morphine 0.2 mg. Anaesthesia was successful in 103 patients with the Sprotte needle and 38 patients with the Quincke needle, and the operating conditions were considered to be excellent. Of the 104 patients in the Sprotte needle group there were ten with PDPH (9.6%), two of which were considered severe. Of the 40 patients in the Quincke needle group there were eight with PDPH (20%), three of which were considered severe. Despite the lower incidence of headache in the Sprotte needle group, this was not statistically significant (P>0.05), due to the difference in population size. We conclude that the 24 gauge Sprotte needle is associated with a comparatively low but clinically relevant incidence of headache in the obstetric population.

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