INCIDENCE OF POST DURAL PUNCTURE HEADACHE AND EASE OF NEEDLE INSERTION: A COMPARISON OF 25 GAUGE QUINCKE AND 25 GAUGE WHITACRE SPINAL NEEDLES IN NIGERIAN OBSTETRIC PATIENTS

Abstract

Sixty seven parturients, ASA 1 and 11, undergoing non- emergent
Caesarean section were studied in a prospective manner. Spinal anaesthesia
was successful in all the patients. They were grouped into two appropriately
matched groups namely 25 gauge Quincke group and 25 gauge Whitacre
group. The insertion characteristics, prevalence of PDPH, response to
treatment, maternal satisfaction and future acceptance of spinal anaesthesia
were determined.
There were no differences in the demographic features between the two
groups. Post dural puncture headache occurred in 9.1% (N=33) of the Quincke
group and none in the Whitacre group. The PDPH was moderately severe in
66.7% of the patients with a mean duration of less than 2.5 days, it was mainly
generalized in 66.7% (N = 33), starting on first post operative day in 66.7% of
patients and 7 hours post op in 1 patient (33.3%). Positive correlation was
established between PDPH prevalence rate and number of attempts at lumbar
puncture (P-value < 0.05).Number of drops of CSF lost during lumbar puncture
did not affect the incidence of PDPH. Patient’s rating of the technique of spinal
anaesthesia was satisfactory in 97.0% (N =33) and 100% (N =34) respectively.
On future acceptance of the spinal anaesthesia, 93.9% (N =33) and 100% (N
=34) respectively will accept spinal anaesthesia in the future.
The use of 25 G Whitacre pencil point spinal needle at not more than
two attempts may eliminate PDPH in the obstetric patients.