Post dural puncture headache in lower limb and lower abdominal surgeries: A comparative study between 25g quincke and 25g whitacre spinal needle

Lidiya, George (2016) Post dural puncture headache in lower limb and lower abdominal surgeries: A comparative study between 25g quincke and 25g whitacre spinal needle. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.


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BACKGROUND AND OBJECTIVE: Post Dural Puncture Headache (PDPH) is a well recognized complication of subarachnoid block. The presence of predisposing factors such as female, young patients, low BMI, inexperience performers, pregnancy and multiple attempts increases the incidence of headache. There are various types of spinal needles used for spinal anaesthesia. The incidence of PDPH by intentional dural puncture is 0.1 to 36%. The incidence is however very less for pencil point needles like Whitacre. (3.1%) compared with traditional cutting needles. In this study we compared the the incidence and severity of postdural puncture headache of two needles, 25G Quincke and 25G Whitacre needle. METHODOLOGY: In this prospective randomized double blinded study, we included 100 patients between the age group 18 – 45 yrs, belonging to ASA 1 and 2 categories posted for lower abdominal and lower limb surgeries. Spinal anesthesia was performed using midline approach at L2-L3 or L3-L4 using one of the above needles and 0.5 % of 2-3ml Bupivacaine was injected and patient turned to supine position. The anaesthesiologists performing the procedure were blinded. Patients were interviewed on day 1,2,3,4 and 5 and were questioned regarding headache, its severity, location, character, duration and associated symptoms like nausea, vomiting, auditory and ocular symptoms. The severity was assessed using a numerical analogue scale. RESULTS: In a total of 100 patients 8 patients (16.5%) developed PDPH. In Quinke group there was a total of 7 patients who developed PDPH compared to that of Whitacre group, where only one patient had PDPH, which was statistically significant. The severity of headache was mild to moderate which was treated with analgesics and intravenous fluids. The incidence of headache was comparable with sex and age, with females and younger patients having higher incidence respectively. CONCLUSION: Thus we concluded that non cutting spinal needles like Whitacre have decreased incidence and severity of PDPH compared to cutting needles like Quincke.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Spinal Anaesthesia ; Post dural puncture headache ; Whitacre needle ; Quinke needle.
Subjects: MEDICAL > Anaesthesiology
Depositing User: Punitha K
Date Deposited: 15 Jun 2018 03:31
Last Modified: 15 Jun 2018 16:23

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