Incidence of Postdural Puncture Headache With 25G Quincke Needle Versus 25G Whitacre Needle After Spinal Anesthesia for Caesarean Section in a Tertiary Care Hospital

Abstract

Background: Postdural puncture headache (PDPH) is the renowned complication from spinal anesthesia in caesarean section (C-section). Advancements in modifications to needle gauge and needle tip over the past five decades have led to a significant reduction in PDPH incidence. The present study aimed to compare the Whitacre needle with the Quincke needle in reducing the PDPH incidence in subjects undergoing Csection. Methodology: A tertiary care hospital recruited 100 patients, who were randomly divided into two groups, with 50 in each group. The patient’s age range was between 18 and 35 years and ASA grades I and II. The 25G-Quincke needle was used for Group A, and the 25G-Whitacre needle was used for Group B patients during C-section. The number of incidences, attempts, demographics, heart rate, mean arterial blood pressure, and efficacy data were analyzed to prevent the PDPH instances. The results were compared statistically by an unpaired t-test for continuous normal data and a Mann–Whitney U test for continuous nonnormal data. The comparison between the two groups was done by the chi-square test or Fisher’s exact test for categorical data. Results: Among the 100 patients, no statistical significance was observed in demographic data, heart rate (HR), or mean arterial blood pressure (MAP) in both groups at different time points. A significant difference between different days and PDPH was seen in group A, and no difference was observed in group B. PDPH severity was higher in group A than in group B. The duration of PDPH between 24 and 48 hours was longer in group A than group B. The number of spinal anesthesia attempts was higher in Group A (94%) than in Group B (86%). Conclusion: The present study concludes that the PDPH incidence rate with 25G Whitacre needles was less compared to 25G Quincke needles. Thus, the pencil-point needle can be used regularly for C-section spinal anesthesia subjects.