RANDOMIZED CONTROLLED STUDY FOR POST DURAL PUNCTURE HEADACHE COMPARING WITH 25 GUAGE QUINCKE AND WHITACRE SPINAL NEEDLES IN OBSTETRIC PATIENTS.

CORRESPONDING AUTHOR:
Dr. Madupathy Veeresham,
Associate Professor,
Department of Anaesthesiology,
Gandhi Medical College.
E-mail: drveeresham79@gmail.com

ABSTRACT: BACKGROUND: Spinal anaesthesia is a safe, economical and reliable technique. It provides profound muscle relaxation, decreases the operative blood loss and produces excellent operating conditions. Avoids foetal as well as maternal risks of general anesthesia. Requires minimum postoperative anaesthesia care and provides adequate post-operative analgesia. But one of the limiting factors in the use of spinal anaesthesia has been the occurrence of post dural puncture headache.⁽¹⁾ Its incidence is highest in obstetric patients. OBJECTIVES: To compare the incidence of post dural puncture headache and the quality of blockade using 25 gauge Quincke and 25 guage Whitacre needles in patients undergoing elective LSCS under spinal anaesthesia. MATERIAL AND METHODS: A prospective comparative study. 200 patients undergoing elective caesarian section under spinal anesthesia. Patients aged between 18 to 35 years. Patients with ASA status I and II. Patients undergoing elective LSCS under spinal anaesthesia. Patients were randomly divided into two groups. Group I is named as group B, group II is named as group D. Group B (n=100) – Receives spinal anaesthesia using 25G Quincke needle. Group D (n=100) – receives spinal anaesthesia using 25G Whitacre needle. Using Vol of Local anaesthetic 0.5% heavy Bupivacaine (2ml). RESULTS AND CONCLUSION: From the present study, it is concluded that 25G Whitacre pencil point needle is associated with lower incidence of PDPH, less duration of PDPH, delayed onset of PDPH, less side effect and less degree of PDPH than 25G Quincke dura cutting needle in pregnant females undergoing elective lower segment cesarean section. Among the pencil-point needles, the 25 gauge Whitacre needle appears to be the preferred choice in terms of low incidence of PDPH. This study was limited to type of needle tip & bore of needle tip for occurrence of PDPH, but PDPH dependent on other factors also. So further study are required to know exact etiology. And the quality of anaesthesia in both onset of blockade and height of sensory and motor blockade was same when using 25G Quincke and 25G Whitacre needles, so there is no difference in quality of blockade. There are no studies available for the comparison of quality of blockade between 25 gauge Quincke and 25 gauge Whitacre needles.

KEYWORDS: Subarachnoid block, regional anaesthesia, Quincke needle, Whitacre needle.