Haemodynamic Effects and Quality of Intrathecal Block in Lateral Decubitus Position using 25G Whitacre versus 25G Quincke Spinal Needles- A Cohort Study

Abstract

Introduction: Various attempts have been made to manipulate the needle designs to counter the adverse effects (hypotension, postdural puncture headache) of spinal anaesthesia. This includes the modification of the tip, the location of the orifice, and the length and material of the needle. Aim: To access if a Whitacre needle is a better substitute than the classical commonly used, Quincke spinal needle along with intraoperative haemodynamic changes and quality of intrathecal block. Materials and Methods: The present stud was a hospital-based cohort study which included 100 patients in the age group of 20-50 years, who belonged to American Society of Anaesthesiologists (ASA) Grade of I and II, and were operated on for lower abdominal and lower limb surgeries under spinal anaesthesia. They were assigned into two groups A and B, wherein group A, 25G Whitacre and in Group B, 25G Quincke needles were used respectively. The primary outcome measures were the differences in the incidence of hypotension, bradycardia, and quality of sensory and motor blockade in the two groups. The t-test and Chi-square test were used. Statistical calculations were done using Statistical Package for the Social Science (SPSS) 21.0 version. Results: There was a noteworthy drop in the blood pressures (Systolic blood pressure (SBP), Diastolic blood pressure (DBP), Mean Arterial Pressure (MAP), where the readings were - group A 117.59 mmHg, group B 117.39 mmHg, group A 73.58 mmHg, group B 73.15 mmHg, group A 88.25 mmHg, group B 87.90 mmHg. But the variance between the two needle groups was statistically insignificant (p>0.05). There was no statistically significant difference between the two needles group to the quality of intrathecal block. Sensory block onset in group A (83.08±12.26 seconds), group B (81.42±17.81 seconds) with p-value 0.410. The mean bromage score in group A (2.90±0.30), group B (2.88±0.33). Conclusion: Both the needles provided excellent sensory and motor blockade and haemodynamic steadiness.