Incidence of Postdural Puncture Headache and Backache, and Success Rate of Dural Puncture: Comparison of Two Spinal Needle Designs

Pan, Peter H.; Fragneto, Regina; Moore, Charles E.; Ross, Vernon H.

doi:10.1097/01.smj.0000078681.07409.f7

Cited by 28 publications

(29 citation statements)

References 15 publications

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“…Thicker needles cause greater trauma and more inflammation in the tissue, resulting in more PDPB (15). However, some studies have shown no difference in PDPB related to the needle size and shape (7,11). The second hypothesis is that repeated spinal puncture attempts cause PDPB (16).…”

Section: Discussionmentioning

confidence: 99%

“…Brooks et al (15) found no difference in PDPB related to the number of redirections of the spinal needle. Pan et al (7) found no difference in PDPB related to the number of attempts of spinal puncture. The Atraucan spinal needle is used with an introducer that is quite thicker than the subarachnoid needle itself.…”

Section: Discussionmentioning

confidence: 99%

“…It is defined as continuous pain that is localized around the site of spinal puncture without any irradiation (6,7). The pathophysiology of PDPB includes muscular relaxation with stretching of spinal ligaments and/or localized tissue trauma (1,2,8,9).…”

Section: Introductionmentioning

confidence: 99%

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Does Atraucan cause more postdural puncture backache?

Abdullayev¹,

Küçükebe²,

Çelik³

et al. 2015

Turk J Med Sci

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Data of 256 pregnant female patients who underwent cesarean delivery under spinal anesthesia at the Adıyaman University Research Hospital between July and August Background/aim: Postdural puncture backache (PDPB) is the most frequent complaint after spinal anesthesia. In the literature its importance is generally overshadowed by postdural puncture headache. We studied two different kinds of spinal anesthesia needles to compare their technical handling capacities and incidences of PDPB.Materials and methods: Data of 256 pregnant female patients undergoing cesarean delivery under spinal anesthesia were collected for the study. Patients were divided into two groups as Group A (n = 109) and Group Q (n = 147) according to the spinal needle used for spinal anesthesia (i.e. 26-gauge atraumatic and 26-gauge Quincke needles, respectively). Backache incidences during a 1-week period postoperatively and handling characteristics of the needles were noted.Results: Spinal anesthesia was successfully performed at one attempt in 92.7% and 86.4% of patients in Groups A and Q, respectively. PDPB was encountered in 62.4% and 44.2% of patients in Groups A and Q, respectively, and the difference was statistically significant (P = 0.037). Conclusion:Both 26-gauge Atraucan and Quincke needles have excellent handling characteristics. PDPB seems to be less common with the 26-gauge Quincke needle than with the Atraucan needle.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Does Atraucan cause more postdural puncture backache?

Abdullayev¹,

Küçükebe²,

Çelik³

et al. 2015

Turk J Med Sci

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“…5 More recent studies on back pain after spinal anesthesia have reported the incidence to be 10% to 29% (Table 4). [43][44][45] One study noted the backaches to be mild in intensity, characterized by local tenderness at the site of injection, and responded to oral anti-inflammatory drugs or resolved spontaneously. 44 The exact duration of the back pain was not noted.…”

Section: Incidence Of Back Pain After Neuraxial Anesthesia: Preexistimentioning

confidence: 98%

Back Pain and Neuraxial Anesthesia

Benzon

Asher

Hartrick

2016

Anesthesia &Amp; Analgesia

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The incidence of back pain after neuraxial anesthesia in the adult population is not different from that after general anesthesia. The pain is usually mild, localized in the low back, rarely radiates to the lower extremities, and has a duration of only a few days. The risk factors for development of back pain include the lithotomy position, multiple attempts at block placement, duration of surgery longer than 2.5 hours, body mass index ≥32 kg/m, and a history of back pain. However, there is no permanent worsening of preexisting back pain after neuraxial anesthesia. The back pain has been attributed to tears in the ligaments, fascia, or bone with localized bleeding; immobility of the spine; relaxation of the paraspinal muscles under anesthesia; flattening of the normal lumbar convexity; and stretching and straining of the lumbosacral ligaments and joint capsules. The addition of an anti-inflammatory drug to the local anesthetic used for skin infiltration may decrease the incidence and severity of back pain. The use of spinal or epidural anesthesia in the adult, non-obstetric and obstetric populations should depend on the advantages offered by the technique and not on the occurrence of back pain after the procedure. Additional studies are needed to confirm the efficacy of epidural dexamethasone, or other steroids, or the addition of an anti-inflammatory drug to the local anesthetic infiltration for the prevention of back pain after neuraxial anesthesia. Future studies should involve a physician with expertise in the evaluation of chronic low back pain to help identify the cause of the back pain and institute appropriate treatment(s).

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“…The incidence of PDPH is directly related to the needle size (gauge) and tip configuration that punctures the dura mater [11,12 ]. Smaller gauge needles with atraumatic, pencil point (non-cutting) tips decrease the risk of PDPH [12 ].…”

Section: Postdural Puncture Headachementioning

confidence: 99%

Neurologic complications of neuraxial analgesia for labor

Birnbach

Hernandez

Zundert

2005

Current Opinion in Anaesthesiology

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Even though the incidence of true neurologic complications arising from neuraxial anesthesia is not known, they appear to be very rare. As anesthesiologists, providing care encompasses knowing the side effects and complications of the anesthetic we provide. Many of the nerve palsies that present in the postpartum patient may be of an obstetric origin, but anesthesiologists should be aware of anesthetic-related complications.

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Incidence of Postdural Puncture Headache and Backache, and Success Rate of Dural Puncture: Comparison of Two Spinal Needle Designs

Abstract: The low complication and failure rates make these two types of smaller size spinal needle design good candidates for dural puncture procedures, such as spinal anesthesia, diagnostic lumbar punctures, and myelograms.

Cited by 28 publications

References 15 publications

Does Atraucan cause more postdural puncture backache?

Does Atraucan cause more postdural puncture backache?

Back Pain and Neuraxial Anesthesia

Neurologic complications of neuraxial analgesia for labor

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