Spinal anaesthesia for caesarean section: Comparison of 25G Whitacre needles with 25G and 23G Quincke needles for technical problems and post-operative complications

Background: The well-known complication of spinal anaesthesia, postdural puncture headache (PDPH), is especially troublesome in young obstetric patients. The needle gauge and configuration of needle tip appear to be the important factors in reducing the incidence of PDPH. We compared the type and size of spinal needles namely whitacre 25G and Quincke 25G and 23G needles in obstetric patients undergoing caesarean section. Methods: Hundred women, age group 18-30 yrs., of ASA grade I and II undergoing spinal anaesthesia for elective caesarean sections were randomly allocated into three groups. In Group I and II, patients received spinal anaesthesia with 23G and 25G Quincke needles whereas in Group III, 25G Whitacre needles were used. The efficacy and usefulness of the needles were studied in preventing the complications like PDPH, backache, non-PDPH and the results obtained were compared statistically. Results: Of the 100 patients, PDPH occurred in 11 patients (11%). The overall incidence of PDPH is 20.5% in 23G Quincke group, 9.09% in 25G Quincke group and 3.03% in 25G Whitacre group. In the present study the incidence of back ache was 23.52% in 23G Quincke group, 15.15% in 25G Quincke group, 9.09% in 25G group. Conclusion: The pencil point 25G Whitacre needle was associated with a lower incidence of PDPH when compared with 25G and 23G Quincke needle and hence could be used routinely for spinal anaesthesia in caesarean section.