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Comparison of post-dural puncture headache using three different types of needles on sub arachnoid block- a clinical study

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Original Article

Author Details : Arathi BH, Namrata Ranganaath

Volume : 3, Issue : 4, Year : 2016

Article Page : 518-524

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Abstract

Background: The study was undertaken to compare the effects on post dural puncture head ache /sequel two with two different types pencil point needles, and one conventional cutting type of needle in patients undergoing lower abdominal surgical and gynecological operative procedures.
Material: Following institutional ethical committee approval the study was undertaken 150 patients ASA I and II grades in the age group of 20 to 50 years and the height between 150 to 168cms, giving informed consent were included.
Patients with h/o chronic head ache, any contra indication to sub arachnoid block and who did not give consent to participate in the study were excluded.
Methods: Patient was randomly allocated in to three groups.
B.P., ECG, HR and SPO2 monitored non-invasively rate, of injection 1ml/15sec, volume 3ml of 0.5% bupivacaine heavy, lateral position and  L3-4 interspace, were kept constant
Group I Quincke 27G needle n=50.
Group II -Sprotte 27G needle n=50.
Group III - Whitacre 27G needle n=50.
The following parameters were compared
Number of attempts, PDPH, Back ache, NPDPH, and Patient acceptability.
The results were compared statistically using Fischer exact test, Analysis of variance and Chi square test.
Results: Statistically analyzing, there was no significant difference in number of attempts in three types of needles with the use of introducer. PDPH 6% in Group 1, 2% in Group 2, and 0% in group 3 inferring that group1 is associated with higher incidence P.D.P.H.
Conclusion: PDPH with pencil point needle compare to Quincke needle in the study group. Sprotte needle is associated with significant failure rate which may limit the use of the same.

Keywords: Anaesthesia technique; Onset of sensory block; SAB; PDPH; NPDPH; Equipment; 27G Whitacre; 27GQuincke; 27G Sprotte

How to cite : Arathi Bh, Ranganaath N, Comparison of post-dural puncture headache using three different types of needles on sub arachnoid block- a clinical study. Indian J Clin Anaesth 2016;3(4):518-524

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