Comparison of post-dural puncture headache incidence among patients undergoing spinal anaesthesia for elective caesarean section by using quincke 25-G and 29-G spinal needles

Authors

  • Tahreem Omer Department of Anaesthesia/ I.C.U, Jinnah Hospital, Usmani Road, Quaid-i-Azam Campus, Lahore, Pakistan
  • Anum Anwar Department of Anaesthesia/ I.C.U, Jinnah Hospital, Usmani Road, Quaid-i-Azam Campus, Lahore, Pakistan
  • Hina Nabi Ahmed Department of Anaesthesia/ I.C.U, Jinnah Hospital, Usmani Road, Quaid-i-Azam Campus, Lahore, Pakistan
  • Mohammad Harris Khan Department of Anaesthesia/ I.C.U, Jinnah Hospital, Usmani Road, Quaid-i-Azam Campus, Lahore, Pakistan
  • Maaz Barlas Department of Anaesthesia/ I.C.U, Jinnah Hospital, Usmani Road, Quaid-i-Azam Campus, Lahore, Pakistan
  • Ashraf Zia Department of Anaesthesia/ I.C.U, Jinnah Hospital, Usmani Road, Quaid-i-Azam Campus, Lahore, Pakistan

DOI:

https://doi.org/10.18203/2320-6012.ijrms20213397

Keywords:

Spinal anesthesia, Elective cesarean, Post dural puncture headache

Abstract

Background: Multiple complications including hypotension, nausea, vomiting, urinary retention, transient neurological symptoms and headache have been associated with spinal anaesthesia. Importantly, post dural puncture headache (PDPH) varies with the type and size of spinal needle employed for inducing anaesthesia. Here, we aimed to compare the frequency of PDPH in patients underwent spinal anaesthesia for elective caesarean section using 25-gauge (G) and 29-G Quincke spinal needle.

Methods: We designed a randomized control trial at Obstetrics and Gynecology Operation Theatres, Jinnah Hospital, Lahore. A total of 152 patients having age 30.28±8.21 years were enrolled in the study and divided into two groups each comprising of 76 patients. In group 1, spinal anaesthesia was performed using 25-G Quincke spinal needle while in group 2 spinal anaesthesia was administered employing 29-G Quincke spinal needle. A standard dose of 10.5-12.0 mg (1.4-1.6 ml) of 0.75% bupivacaine is infiltrated in subarachnoid space at lumber region L3-L4 or L4-L5 following aseptic measures. The patients were evaluated for PDPH during the follow up period.

Results: The previous history of PDPH was observed in 20.39% patients. The comparative study showed that the PDPH was observed in 12 (15.7%) patients in group 1 while the group 2 revealed PDPH in only 2 (2.6%) patients.

Conclusions: Thus 29-G spinal needle can be regarded as a better option to reduce PDPH in patients subjected to spinal anaesthesia for elective cesarean in contrast to the use of 25-G Quincke spinal needle.

References

Zhang D, Chen L, Chen X, Wang X, Li Y, Ning G et al. Lower incidence of postdural puncture headache using whitacre spinal needles after spinal anesthesia: A meta‐analysis. Headache: The Journal of Head and Face Pain. 2016;56(3):501-10.

Xu H, Liu Y, Song W, Kan S, Liu F, Zhang D etal. Comparison of cutting and pencil-point spinal needle in spinal anesthesia regarding postdural puncture headache: A meta-analysis. Medicine. 2017;96(14).

Simic SS, Kopitovic AS, Zikic TR, Knezevic J, Radmilo L, Simic DS. Post-dural puncture headache: epidemiology, onset mechanisms, clinical symptoms, diagnosis and therapy. Medicinski Pregled. 2019;72(11-12):383-9.

Kwak KH. Postdural puncture headache. Korean journal of anesthesiology. 2017;70(2):136.

Meshram S, Deshmukh P, Sabale P, Bankar N, Chandak VC. Incidence of Post Dural Puncture Headache in Our Set Up with Quincke Spinal Needle: An Observational Crossectional Study. Indian Journal of Forensic Medicine & Toxicology. 2020;14(4):6303-9.

Haller G, Cornet J, Boldi MO, Myers C, Savoldelli G, Kern C. Risk factors for post-dural puncture headache following injury of the dural membrane: a root-cause analysis and nested case-control study. International journal of obstetric anesthesia. 2018;36:17-27.

Haller G, Cornet J, Boldi MO, Myers C, Savoldelli G, Kern C. Risk factors for post-dural puncture headache following injury of the dural membrane: a root-cause analysis and nested case-control study. International journal of obstetric anesthesia. 2018;36:17-27.

Ayub F, Ahmad A, Aslam KZ, Saleem I. Frequency of headache with 25G or 27G quincke needles after spinal anesthesia in patients undergoing elective cesarean section. Anaesthesia, Pain & Intensive Care. 2019;19:170-3.

Lotfy Mohammed E, El Shal SM. Efficacy of different size Quincke spinal needles in reduction of incidence of Post-Dural Puncture Headache (PDPH) in Caesarean Section (CS). Randomized controlled study. Egyptian Journal of Anaesthesia. 2017;33(1):53-8.

Kwak KH. Postdural puncture headache. Korean journal of anesthesiology. 2017;70(2):136.

Pirbudak L, Ozcan HI, Tümtürk P. Postdural puncture headache: Incidence and predisposing factors in a university hospital. Ağrı. 2019;31(1):1-8.

Khraise WN, Allouh MZ, El-Radaideh KM, Said RS, Al-Rusan AM. Assessment of risk factors for postdural puncture headache in women undergoing cesarean delivery in Jordan: a retrospective analytical study. Local and Regional Anesthesia. 2017;10:9.

Lotfy Mohammed E, El Shal SM. Efficacy of different size Quincke spinal needles in reduction of incidence of Post-Dural Puncture Headache (PDPH) in Caesarean Section (CS). Randomized controlled study. Egyptian Journal of Anaesthesia. 2017;33(1):53-8.

Shivan M, Smita P, Parul M, Keshaban M. Effect of reinsertion of the spinal needle stylet after spinal anaesthesia procedure on post dural puncture headache in women undergoing caesarean delivery. Indian Journal of Anaesthesia. 2020;64(11):971.

Eskander FS, Ibrahim DA, Hamza AH, Mahmoud MG. Comparative Study between 25 Gauge Spinal Needle (Quincke) versus (pencil point) As Regarding incidence of Post Dural Puncture Headache. QJM: An International Journal of Medicine. 2020;113(1):hcaa039-057.

Mehraj A, Raja A, Rehman S, Adil N. To compare the incidence of post dural puncture headache with pencil point 25 gauge whitacre verse cutting 25 gauge quincke spinal needle in patients for c section under spinal anaesthesia. Pakistan armed forces medical journal. 2020;70(6):1897-901.

Meshram S, Deshmukh P, Sabale P, Bankar N, Chandak VC. Incidence of Post Dural Puncture Headache in Our Set Up with Quincke Spinal Needle: An Observational Crossectional Study. Indian Journal of Forensic Medicine & Toxicology. 2020;14(4):6303-9.

Zorrilla-Vaca A, Mathur V, Wu CL, Grant MC. The impact of spinal needle selection on postdural puncture headache: a meta-analysis and metaregression of randomized studies. Regional Anesthesia & Pain Medicine. 2018;43(5):502-8.

Rahman MA, Alam A, Mandal MA, Kamruzzaman M, Kabir MA, Begum S etal. Incidence of Postdural Puncture Headache after Caesarean Section Comparison Between 25G and 27G Quincke Variety of Spinal Needle. KYAMC Journal. 2012;(2):762-69.

Mandal AP, Gyani PK, Kumar S, Kumar R. Comparative Evaluation of Different Needle Gauge of Needle for Spinal Anesthesia in Cesarean Section for Post-Operative Complication. Acad. Anesthesiol. Int. 2019;4(2):118-21.

Islam MA, Begum A, Shahida SM. Comparison of 27 G Quincke and 25 G Quincke Needles for Post Dural Puncture Headache in Caesarean Section. Journal of Armed Forces Medical College, Bangladesh. 2016;12(1):17-21.

Downloads

Published

2021-08-25

How to Cite

Omer, T., Anwar, A., Ahmed, H. N., Khan, M. H., Barlas, M., & Zia, A. (2021). Comparison of post-dural puncture headache incidence among patients undergoing spinal anaesthesia for elective caesarean section by using quincke 25-G and 29-G spinal needles. International Journal of Research in Medical Sciences, 9(9), 2588–2592. https://doi.org/10.18203/2320-6012.ijrms20213397

Issue

Section

Original Research Articles