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At least 325 records · Page 18Linked to original sources
PubMed1994

The use of Quincke and Whitacre 27-gauge needles in orthopedic patients: incidence of failed spinal anesthesia and postdural puncture headache.

This study examined the incidence of failed spinal anesthesia and postdural puncture headache using a 27-gauge Whitacre and a 27-gauge Quincke needle in patients undergoing elective inpatient orthopedic procedures. The overall rate of failed spinal anesthesia was 8.5% [95% confidence interval (CI) = 4.6%-12.4%] (n = 17) in the Quincke group (n = 199) and 5.5% [95% CI = 2.3%-8.7%] (n = 11) in the Whitacre group (n = 199). This difference was not statistically significant. The overall incidence of postdural puncture headache (PDPH) was 0.8%; 1.1% [95% CI = 0%-2.4%] (n = 2) in the Quincke group and 0.5% [95% CI = 0%-1.5%] (n = 1) in the Whitacre group. These differences were not statistically significant. All headaches were classified as mild and resolved spontaneously with conservative management. The mean time for withdrawal of the stylet to appearance of cerebrospinal fluid was 10.8 +/- 6.9 s in the Quincke (n = 31) and 10.7 +/- 6.8 s in the Whitacre group (n = 33). These differences were not statistically significant. Our results suggest that both needles are associated with a very low incidence of PDPH and an incidence of failed anesthesia of 5.5%-8.5%.

Adolescent↗
PubMed2004

Incidence of postdural puncture headache and backache, and success rate of dural puncture: comparison of two spinal needle designs.

OBJECTIVES: The goal of this randomized study was to compare the incidence of postdural puncture headache (PDPH) and postdural puncture backache (PDPB), and the success rate between two small-gauge spinal needle designs used in women undergoing subarachnoid block anesthesia. METHODS: After Institutional Review Board approval, 215 patients presenting for tubal ligation were randomly assigned to have 26-gauge Atraucan (AT group) or 25-gauge Whitacre (WH group) spinal needles used in their spinal anesthesia. The number of attempts to successful cerebrospinal fluid return and the success rate of the spinal blockade were documented. Postoperatively, an investigator blinded to the study interviewed patients daily. RESULTS: The incidence of PDPH was similar between the AT group (3.9%) and the WH group (4.0%). The total duration of all PDPHs was 5 days for the AT group and 15 days for the WH group. Both groups had a similar one-attempt success rate of 61% (AT group) and 62% (WH group). Failure to obtain cerebrospinal fluid occurred in only one in the AT group and two in the WH group. The incidence of PDPB was similar and the severity was mild in both groups. CONCLUSIONS: The low complication and failure rates make these two types of smaller size spinal needle design good candidates for dural puncture procedures, such as spinal anesthesia, diagnostic lumbar punctures, and myelograms.

Adult↗
PubMed1994

Comparison of the force required for dural puncture with different spinal needles and subsequent leakage of cerebrospinal fluid.

An in vitro model was used to determine the force required to pierce bovine dura with a range of new spinal needles and to measure the subsequent leakage rate of cerebrospinal fluid (CSF). A significantly greater force was required to pierce the dura with pencil-point style needles compared to Quincke needles of the same size. Quincke needles caused a greater loss of CSF than their pencil-point equivalents. The results suggest that there is not likely to be a significant reduction in postdural puncture headache (PDPH) using a 27-gauge pencil-point needle compared to a 25-gauge needle that may be easier to use. Different makes of the same design and gauge of needle showed significant differences in the amount of CSF leakage, which may influence the clinician's choice of needle.

Anesthesia, Epidural↗