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Postdural puncture headache: a randomized prospective comparison of the 24 gauge Sprotte and the 27 gauge Quincke needles in young patients.
This study was designed to compare the frequency of postdural puncture headaches (PDPH) using the 24 gauge Sprotte and the 27 gauge Quincke spinal needles in a population of patients less than 45 yr of age undergoing spinal anaesthesia for non-obstetrical surgery. Patients were randomly assigned to receive spinal anaesthesia with either the 24 gauge Sprotte spinal needle (n = 46) or the 27 gauge Quincke spinal needle (n = 47). Patients were interviewed on either postoperative day one or two and on postoperative day three. A PDPH was defined as a headache involving the occipital or frontal areas that is made worse when assuming either the sitting or standing position. Ninety-three patients were included in the analysis of data. The overall incidence of PDPH was 14% (13 of 93), and no difference was found between the Sprotte (15.2%) and Quincke (12.8%) needles. The distribution of the PDPHs by severity was not different between the two groups. None of the 13 patients with PDPHs required on epidural blood patch for relief of symptoms. Both the Sprotte needle and the Quincke needles were judged as easy to use and both required the same number of attempts in order to locate cerebrospinal fluid (first attempt successful: 73.9% versus 66%). Neither patient satisfaction nor the acceptability of spinal anaesthesia for a future procedure was adversely affected by the occurrence of a PDPH. The results of this study suggest that the risk of PDPH after spinal anaesthesia in young patients is similar using either the 24 gauge Sprotte or the 27 gauge Quincke spinal needle.
Combined spinal-epidural technique for diagnostic lumbar puncture in the intensive care unit.
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Second lumbar puncture in aseptic meningitis.
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Acute subdural hematoma after subdural punctures.
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Hazards of anticoagulation therapy shortly after lumbar puncture.
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Gradients of monoamine metabolites in relation to position of the lumbar puncture needle.
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Headache after lumbar puncture.
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Post dural puncture headache.
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Intrathecal catheter as a secondary prophylaxis of postdural puncture headache.
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Significance of polymorphonuclear leukocytes in traumatic lumbar punctures.
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Intrathecal injections in rats by percutaneous lumbar puncture.
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Timing of lumbar puncture in severe childhood meningitis.
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Preventing headache after lumbar puncture. Most doctors are unaware of features of headache after lumbar puncture.
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Is lumbar puncture alive and well?
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Using music therapy as distraction during lumbar punctures.
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Routine use of CT prior to lumbar puncture.
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