POSTDURAL PUNCTURE HEADACHE - A RANDOMIZED PROSPECTIVE COMPARISON OF THE 24 GAUGE SPROTTE AND THE 27 GAUGE QUINCKE NEEDLES IN YOUNG-PATIENTS

This study was designed to compare the frequency of postdural puncture headaches (PDPH) using the 24 gauge Sprotte and the 27 gauge Quincke spinal needles in a population of patients less than 45 yr of age unde rgoing spinal anaesthesia for non-obstetrical surgery. Patients were r andomly assigned to receive spinal anaesthesia with either the 24 gaug e Sprotte spinal needle (n = 46) or the 27 gauge Quincke spinal needle (n = 47). Patients were interviewed on either postoperative day one o r two and on postoperative day three. A PDPH was defined as a headache involving the occipital or frontal areas that is made worse when assu ming either the sitting or standing position. Ninety-three patients we re included in the analysis of data. The overall incidence of PDPH was 14% (13 of 93), and no difference was found between the Sprotte (15.2 %) and Quincke (12.8%) needles. The distribution of the PDPHs by sever ity was not different between the two groups. None of the 13 patients with PDPHs required an epidural blood patch for relief of symptoms. Bo th the Sprotte needle and the Quincke needles were judged as easy to u se and both required the same number of attempts in order to locate ce rebrospinal fluid (first attempt successful: 73.9% versus 66%). Neithe r patient satisfaction nor the acceptability of spinal anaesthesia for a future procedure was adversely affected by the occurrence of a PDPH The results of this study suggest that the risk of PDPH after spinal anaesthesia in young patients is similar using either the 24 gauge Spr otte or the 27 gauge Quincke spinal needle.