Comparative Study Of Post Dural Puncture Headache By Using 25G Vs. 27G Quincke Spinal Needles In Cesarean Section Surgery

Abstract

Post-Dural puncture headache (PDPH) is a prevalent complication following spinal anesthesia, particularly in cesarean sections, and the size of the needle used may significantly influence its incidence. This study aimed to compare the incidence of PDPH and the severity of associated pain between two commonly used spinal needles: the 25-gauge (25G) and the 27-gauge (27G) Quincke needles. The primary objective was to evaluate the differences in PDPH occurrence and pain severity, as measured by the Total Numeric Rating Scale (TNRS), between patients administered spinal anesthesia with either 25G or 27G needles. Data were meticulously collected from three hospitals in Lahore, focusing on patients who underwent cesarean sections under spinal anesthesia. The occurrence of PDPH was documented, and pain scores were assessed using the TNRS. Statistical analyses were performed using t-tests to compare means, Chi-Square tests to evaluate categorical data, and Pearson correlation coefficients to assess relationships between variables. The findings revealed a higher incidence of PDPH in patients who received the 27G needles (43.2%) compared to those who received the 25G needles (28.2%). Furthermore, patients experiencing PDPH reported significantly higher TNRS scores, with a mean score of 11.25. Statistical analysis confirmed significant differences between the two groups, with a t-value of -32.53 (p = 0.00) and a Chi-Square value of 180.00 (p = 0.00). Additionally, strong negative correlations were identified between needle size and both the incidence of PDPH (r = -1.00) and TNRS scores (r = -0.925), indicating that as the gauge of the needle increased, the incidence of PDPH and pain severity decreased. The results of this study suggest that the use of 25G Quincke needles is associated with a reduced risk of PDPH and lower pain severity compared to 27G needles. These findings underscore the importance of proper needle selection in spinal anesthesia, as it can significantly enhance patient outcomes and minimize complications. Further research is warranted to explore the underlying mechanisms and to establish standardized practices for needle selection in clinical settings.

Keywords: 25G vs 27G Quincke needles, PDPH, TNRS.