scholarly journals COMPARISON OF POST-DURAL PUNCTURE HEADACHE IN SPINAL ANAESTHESIA USING 25-GAUGE VERSUS 29-GAUGE SPINAL NEEDLE

2018 ◽  
Vol 7 (36) ◽  
pp. 4035-4037
Author(s):  
Sanjeev Kumar ◽  
Ashutosh Kumar
Keyword(s):  
Spinal Anaesthesia ◽  
Dural Puncture ◽  
Spinal Needle ◽  
Post Dural Puncture Headache

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 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 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 Complications of Continuous Spinal Anaesthesia

1992 ◽  
Vol 20 (4) ◽  
pp. 417-425 ◽  
Author(s):  
P. J. Peyton
Keyword(s):  
Spinal Anaesthesia ◽  
Current Practice ◽  
Dural Puncture ◽  
Single Shot ◽  
Continuous Spinal Anaesthesia ◽  
Post Dural Puncture Headache ◽  
History Of ◽  
Nerve Trauma

The practice of continuous spinal anaesthesia dates back to the beginning of the century. The history of the technique, and the problems which accompanied each method used, are reviewed. Complications encountered in current practice include post dural puncture headache; technical difficulties with insertion and removal of catheters; and a higher potential for nerve trauma, neurotoxicity, and method failure than seen with single-shot spinal anaesthesia. The question of the place of the technique in modern anaesthesia is addressed.

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

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