Anesthesia & Clinical Research
Open Access

Abstract

Comparison of 25 Gauge Cutting with Noncutting Needles for Post Dural Puncture Headache in Obstetric Patients

Tanveer Baig

Introduction: Post dural puncture headache (PDPH) is the most common complication of dural puncture, occurring in up to 36.5% of spinal taps. Clinical and laboratory research have shown that use of small gauge needles particularly of the pencil point design is associated with lower incidence of PDPH then traditional cutting needles.

Objective: To compare the frequency and severity of postdural puncture headache between 25G cutting and non cutting needles used for subarachnoid block in patients undergoing cesarean section. Study design: Randomized clinical trial Place and duration of study: Department of anesthesiology, Dow university of Health Sciences, Karachi, Pakistan, during January 10, 2008 to July 9, 2008 Subject and methods: Sixty consecutive under the age of 35 years with class ASA I and II women were enrolled and randomly divided into two groups of equal size with 30 women in each group. The frequency and severity of PDPH was compared between 25G cutting and non cutting needles in patients under going elective cesarean section under spinal anaesthesia. Results: The average age of the patients was 30.23 ± 6.6 years and 31.34 ± 5.6 in group I and group II respectively. There was no difference in baseline characteristics between groups as shown in Table 2. Lumbar puncture was successful in most of the patients in first attempt, 17 (90%) and 25 (83.3%) in group I and group II respectively. Out of 60 patients, 21.7% (13/60) patients had developed post dural puncture headache. Eleven (36.7%) of 30 patients had observed post dural puncture headache in group-I (25G cutting needles) and only 2 of 30 patients (6.7%) in group-II (25G non cutting needles). Severity of post dural puncture headache was significantly high in group-I than group-II on day 2 and day 3, (Chi-square test=8.56, df=3, P=0.036). None of the patients had traumatic punctures.

Conclusion: The frequency and severity of PDPH was higher in 25G cutting spinal needle group as compared to non cutting needle.