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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.
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