Evaluation of 25G and 27G Quincke Spinal Needles for Post-Dural Puncture Headache Following Caesarean Section

Introduction: Postdural Puncture Headache (PDPH) remains a well-recognized health concern following a spinal anesthesia for a caesarean section (CS). To weigh the PDPH during CS, a comparison was made between 25G and 27G Quincke spinal needles. Methods: The prospective, single blind, cross sectional study study was conducted at the Centurion University, Vizianagaram, Vishakhapatnam, India,85 primiparous women aged 18-36 years were selected and classified as group 1 & 2, based on the type of needle used to receive anaesthesia for elective CS. The subjects were allocated to receive spinal anaesthesia with either a 25G spinal needle (group 1, n=85) or with a 27 G needle (group 2, n=85). Data collection was done focusing on the incidence of PDPH postoperatively. Data analysis was done by STATA 17 software. Results: A total of 170 pregnant women of CS were included in this study, who were divided in to two groups (n=85 for each group) based on the needle used during spinal anaesthesia as group 1with 25G and group 2 with 27G needle size. Age and weight distribution of pregnant women were similar in both groups, with the mean age of 27.1 years in group 1 and 26.5 years in group 2. The mean weight of the both groups were 62.0kg and 60.9kg respectively for group1 & 2. The heart rate (82.8 vs 81.6bpm) and mean BP (91.0 vs 90.1mmhg) between group 1 vs group 2 was similar between the two groups. The incidence of PDPH was higher in group 1 (25G) (16.5%) subjects than in group 2 subjects (27G) (6.1%), and the incidence rate is significantly lower (p<0.05) in the finer needle size. The trials required to attain CSF is higher in group 2, and a finer needle takes more attempts to collect CSF. Conclusion: This study concludes that due to the lower frequency of PDPH with a 27G needle, it should be given preference for applying spinal anaesthesia over a 25G needle. Moreover, it is technically more time-consuming to administer spinal anesthesia with a 27G needle than other.