Comparative Study on the Effects and Complications of Transverse Insertion of Two Fine Gauge Quincke's Spinal Needles 26 and 29 G in Spinal Anesthesia

Abstract

Introduction: Spinal anesthesia is one of the most commonly used techniques in modern anesthesia. Spinal needles have evolved over time to increase efficacy and decrease complications. Fine gauge spinal needles technically consume more time but are advisable in certain clinical conditions such as raised intracranial pressure and when patient well-being and comfort are the priorities. Hence, we undertook this study to compare the effects and complication of transverse insertion of Quincke's spinal needle 26 G (gauge) and 29 G. Materials and Methods: Hundred patients of age 18–40 years posted for lower abdominal and lower limb surgeries were allocated into two groups of 50 each to receive spinal anesthesia with 3 ml of 0.5% bupivacaine using 26 G or 29 G Quincke's spinal needle. All the patients were evaluated for the time of drug administration, number of attempts, time to attain sensory blockade up to T8 level, time to attain motor blockade up to bromage Grade 3, and incidence of post-dural puncture headache (PDPH) and post-dural puncture backache. Results: Demographic data were comparable in both groups. The PDPH incidence on 3rd day for 29 G Quincke's was 0% while for 26 G Quincke's was 12%. There was statistically significant difference when 26 G Quincke's was compared with 29 G Quincke's for number of attempts, time of drug administration, time to attain motor and sensory block. Conclusion: 29 G Quincke's spinal could be used to provide spinal anesthesia in young adult patients owing to adequate sensory and motor blockade with no incidence of PDPH and backache.