Complications with 25-gauge and 27-gauge Whitacre needles during combined spinal-epidural analgesia in labor

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.