Postdural puncture headache A comparison between 26‐ and 29‐gauge needles in young patients

Flaatten, Hans; Rodt, S. Å.; Vamnes, Jan Sverre; Rosland, Jan Henrik; Wisborg, Torben; Koller, Moshe

doi:10.1111/j.1365-2044.1989.tb11167.x

Cited by 121 publications

(94 citation statements)

References 9 publications

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“…We did not find a significant difference in the present study, but this may be due to the rather small group size. Most previous studies concerning PDPH were done in spinal anaesthesia with smaller needles [12][13][14][15]. Large needle size is definitely associated with more frequent PDPH [10,11,16].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic lumbar puncture. Comparative study between 22–gauge pencil point and sharp bevel needle

et al. 2005

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Post–lumbar puncture headache is a frequent clinical problem. Needle design is expected to reduce post–puncture headache. In this study, we compared two different lumbar puncture needle designs in diagnostic lumbar puncture and analysed post–dural puncture headache (PDPH) and social and economical harm associated with the diagnostic lumbar puncture procedure. This prospective, controlled study consisted of 80 consecutive adult patients requiring elective diagnostic lumbar puncture due to various neurological symptoms. Lumbar puncture was completed either with Spinocan ® 22 G sharp bevel needle or Whitacre ® 22G pencil point needle. Patients were asked about previous headache symptoms and pain provoked by puncture. One week after the lumbar puncture all patients were interviewed by telephone and occurrence and type of headache, headache intensity, medication and frequency of impairment in activities of daily living were asked. Need for epidural blood patch was also recorded. Thirty–three of 78 (42%) patients experienced headache after diagnostic lumbar puncture and in 26 (33%) the headache could be classified as PDPH. There were no statistically significant differences between needle types in the frequency of common headache, PDPH, puncture pain intensity, need for epidural blood patch or sick leave. Also, there were no other complications except local back pain or headache. In this study, the needle design did not affect the frequency of PDPH. Also, PDPH was common, occurring in 33% cases and caused a considerable amount of disturbance in daily activities. Seeking help for this condition was insufficient and only part of these PDPH patients were treated with epidural blood patch.

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Section: Discussionmentioning

confidence: 99%

Diagnostic lumbar puncture. Comparative study between 22–gauge pencil point and sharp bevel needle

et al. 2005

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“…16 Many of the headaches that occur after spinal anaesthesia may not be the result of dural puncture and should be differentiated from the PDPHs by the patient's history. 13,25 The relatively high rate of PDPH that we describe for both spinal needles requires explanation. When the present study is compared with others using the 27 gauge Quincke needle, it appears that the patients in the present study were younger and followed up more closely than those reported by Flanagan et al 1 (PDPH rate of 3.7%).…”

Section: Discussionmentioning

confidence: 93%

“…2,15,~9,24-27 While use of the 29 gauge Quincke needle has been reported to result in an incidence of PDPH between 0% and 2%, the failure rate of between 1.2% and 8% may make its use impractical. 20,24,25,28,29 Variability in the reported frequency of PDPH may be a result of differences in patient populations, such as age and sex 2,~2 or intraoperative variables such as patient position, bevel orientation, t4,3~ type and baricity of anaesthetic agent, 26 addition of opioid 31 and intraoperative sedation. 7 The psychosomatic component of PDPH should be considered 32,33 as well as the definition of PDPH used and the method of patient follow-up employed.…”

Section: Discussionmentioning

confidence: 99%

Postdural puncture headache: a randomized prospective comparison of the 24 gauge Sprotte and the 27 gauge Quincke needles in young patients

1993

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“…This is further facilitated by not using introducer needle. The incidence of headache using 26 G spinal needle, has variably been reported as 0.4%, 7.5% and 37.2% by different authors [14,15,16]. This wide range of variation may be due to factors like age, sex.…”

Section: Discussionmentioning

confidence: 99%

Lateral Approach : A Better Technique for Spinal Anaesthesia in the Modern Era

Khanduri

2002

Medical Journal Armed Forces India

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The most commonly used technique in routine spinal anaesthesia practke is the midline approach. compared to the lateral or paramedian approach. With the better understanding of the technique and introduction of fine gauge spinal needles. this practice needs a rethinking. Lateral approach was used in 60 patients undergoing different surgical procedures below the umbilicus, using 24 or 25 gauge, Quincke spinal needle without an introducer. The result was gratifying. In 77% of the cases the subarachnoid space could be entered in the first attempt. There was no failure. No patient complained of postdural puncture headache or post operative backache. Only one patient reported paraesthesia during needle placement without any residual effect. Various other advantages of the technique are discussed. Thus with due practice, lateral approach is found to be superior in modern day spinal anaesthesia.

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Postdural puncture headache A comparison between 26‐ and 29‐gauge needles in young patients

Cited by 121 publications

References 9 publications

Diagnostic lumbar puncture. Comparative study between 22–gauge pencil point and sharp bevel needle

Diagnostic lumbar puncture. Comparative study between 22–gauge pencil point and sharp bevel needle

Postdural puncture headache: a randomized prospective comparison of the 24 gauge Sprotte and the 27 gauge Quincke needles in young patients

Lateral Approach : A Better Technique for Spinal Anaesthesia in the Modern Era

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