INCIDENCE OF POSTDURAL PUNCTURE HEADACHE IN CAESAREAN SECTION : A COMPARISON OF 25 G QUINCKE AND 25 G WHITACRE NEEDLE

DR. PRIYANKA MONDAL; DR. INDRANI CHAKRABORTY; Prof. AMITA ACHARJEE

Volume : VIII, Issue : XII, December - 2019

INCIDENCE OF POSTDURAL PUNCTURE HEADACHE IN CAESAREAN SECTION : A COMPARISON OF 25 G QUINCKE AND 25 G WHITACRE NEEDLE

Dr. Priyanka Mondal, Dr. Indrani Chakraborty, Prof. Amita Acharjee

Abstract :

Background: Postdural puncture headache (PDPH) is a distressing complication of the subarachnoid block. Most of the previous studies showed that there were more incidence of PDPH in Quincke needle than Whitacre needle. But none of the studies mentioned about direction of needle during withdrawl. Hence, this study was designed to compare the onset, incidence, duration, severity of PDPH between 25G Quincke, 25G Whitacre needle, in patients at risk of PDPH. Materials and Methods: 18–35 years of three hundred twenty four, ASA I and II obstetrics patient posted for Cesarean section under subarachnoid block, were randomly assigned into two groups W and Q, where 25G Whitacre and 25G Quincke spinal needles were used, respectively. The primary objective of the study was to find out the difference in incidence of PDPH, if any, between the two groups, by using the Fisher’s exact test 2–tailed. Results: The incidence of PDPH was 8.02% with group Q and 3.09% which was not statistically significant (P=0.087) difference between two groups. Conclusion: Both 25G Quincke and Whitacre needle can be used for spinal anaesthesia in obstetric patient as there is no significant difference in onset, duration, severity, location and incidence of PDPH. However 25G Quincke needle is technically easier for insertion and significantly low price. Therefore, 25G Quincke needle can be used for spinal anaesthesia in obstetrics patients with bevel of the needle parallel to the dural fibers both during insertions and withdrawl.