R. Landau et al., Complications with 25-gauge and 27-gauge Whitacre needles during combined spinal-epidural analgesia in labor, INT J OB AN, 10(3), 2001, pp. 168-171
Needle size and shape may influence the incidence of paresthesias, post-dur
al puncture headache and other complications during combined spinal-epidura
l (CSE) procedures. We have noted a relatively high incidence of transient
paresthesias during placement of the spinal needle during CSE for labor ana
lgesia. The purpose of this study was to compare the occurrence of paresthe
sia and post-dural puncture headache in parturients who received CSE analge
sia with either a 25-gauge or 27-gauge Whitacre needle. In a prospective ob
servational study, data were gathered from 478 consecutive women receiving
labor analgesia. Incidence, duration, and character of any paresthesias upo
n spinal needle placement and the incidence and treatment of headache were
recorded. The incidence of paresthesia with the two needles was similar (16
% with 25-gauge vs 15.4% with 27 gauge) but the incidence of post-dural pun
cture headache was higher with the 35-gauge needle (4% vs 0.7% with 27 gaug
e, P < 0.05). Our data suggest that with Whitacre needles, 37-gauge might b
e preferable to 25-gauge needles to reduce the rate of post-dural puncture
headache in parturients but that they do not alter the incidence of transie
nt paresthesias. (C) 2001 Harcourt Publishers Ltd.