The Effect of Spinal Needle Type on Post-Dural Puncture Headache in Spinal Anesthesia: Prospective Randomized Study

Abstract

Background: Postdural puncture headache is a headache that occurs after a dura puncture, especially in caesarean sections, and afects patient comfort and mobilization. In this study, we compared the efects of pencil-tipped spinal needles and especially curved, bilateral atraumatic spinal needles in individuals undergoing elective caesarean sections. Methods: A total of 886 patients, aged 20–50 years, who had cesarean sections with spinal anesthesia and had American Society of Anesthesiologists II and III scores, were included in the study. The patients were allocated into 3 groups using the closed envelope randomization technique: Group 1 (n=250) received spinal insertions using 25-gauge pencil-point needles; Group 2 (n=245) received spinal insertions using 26-gauge atraumatic needles; and Group 3 (n=250) received spinal insertions using 27-gauge pencil-point needles. Records were kept of the quantity of spinal needle referrals, the type of treatment, the length of hospital stays, and complications. Results: In the study, 745 patients who had cesarean section operations under spinal anesthesia were further analyzed. The mean incidence of post-dural puncture headache (PDPH) was 3.2% (n=24). The incidence of PDPH was higher in group 2 than in group 3 and group 1 (Group 1: 2.8%; Group 2: 6.8%; Group 3: 0%) (P < 0.05). Among other complications, low back, back, shoulder, and surgical complications were similar for all 3 groups. Conclusion: In caesarean section operations, pencil-point spinal needles were found to have a lower incidence of postdural puncture headache than Atraucan-cut needles, regardless of needle thickness.