A Clinical Study to Compare 25 G Whitacre and Quincke Spinal Needles for Incidence of Post Dural Puncture Headache (PDPH) and Failed Spinal Anaesthesia

Abstract

Post dural puncture headache (PDPH) is the most distressful complication of spinal anaesthesia. The modifiable risk factors include spinal needle type and size. Thus the present study was attempted with a primary aim to compare 25G Whitacre and 25G Quincke spinal needles with respect to the incidence, onset and severity of PDPH, incidence of failed spinal anaesthesia (FSA) and the quality of block achieved (sensory and motor). The study was conducted from December 2017 to August 2019. 120 patients posted for lower abdominal and lower limb surgeries were allocated in two groups of 60 each. Patients received sub arachnoid block (SAB) with 15 mg of 0.5% bupivacaine using 25 G Whitacre needle in Group A and using 25G Quincke’s needle in Group B. All the patients were evaluated for incidence, onset and severity of PDPH at 24hr, 48hrs and 72hrs after SAB, rate of FSA and quality of block using modified bromage scale and pinprick method. Demographic data was comparable in both the groups. Incidence of PDPH was 1.6% in Whitacre group as compared to 15% in Quincke’s group . However the result was statistically insignificant for rate of FSA and quality of block achieved. It is concluded that pencil point 25 G Whitacre needles are associated with a lower incidence of PDPH as compared to cutting 25G Quincke spinal needle and thus should be used in a population that is at high risk of developing PDPH.