Abstract
Objective
To compare the frequency and severity of post dural puncture headache in obstetric patients using 22G Quincke, 25G Quincke.
Design:
Comparative, randomized, interventional study.
Place and Duration of Study:
In Karbala Obstetrics and Gynecology Hospital and Al Hassan Al-Mojtaba Teaching Hospital from January 2024 to March 2024.
Methods
We included 62 female patients categorized as ASA I (normal healthy patients) and ASA II (patients with mild systemic disease), all of whom were full-term pregnant women, 18 to 45 years of age, scheduled for elective Caesarean section, under spinal anesthesia, were randomized into two groups: Group I (22G Quincke spinal needle: n = 31), Group II (25G Quincke spinal needle: n = 31). Spinal anesthesia was performed with 2.5–3.5 ml 0.5% hyperbaric bupivacaine using 22G Quincke spinal needle (Group I), 25G Quincke spinal needle (Group II) at L3-4 inter-vertebral space. Each patient was assessed daily for three consecutive days following Caesarean section. Frequency and severity of post dural puncture headache (PDPH) was recorded.
Results
Frequency of PDPH following the use of 22G Quincke (Group I), 25G Quincke (Group II) was 67.7% (21/31), 25.8% (8/31) respectively. In Group I, PDPH was mild in 2 patients, moderate in 5 patients and severe in 14 patients. In Group II, it was mild in 4, moderate in 2 and severe in 2 patients. Most of the patients with PDPH developed it on the 1st and 2nd postoperative day.
Conclusion
When using a 25G Quincke spinal needle, the frequency and severity of PDPH was significantly lower than when a 22G Quincke needle was used.