A COMPARATIVE STUDY OF 25-G vs. 27 QUINCKE NEEDLES ON PDPH IN HOLISTIC PATIENTS IN RECOVERY AFTER ELECTIVE CAESAREAN SECTION

Abstract

Background: Post-Dural Puncture Headache (PDPH) is still considered to be one of the most common complications following spinal anesthesia, especially when it is used in obstetric clients undergoing elective Caesarean Section. The PDPH incidence highly depends on the gauge and design of the spinal needle deployed in the administration of anesthesia. The most widely used Quincke needles (25-G and 27-G) are used, but still, the relationship between their impact on PDPH occurrence, severity, and the overall patient recovery is a controversial topic. This research was intended to give empirical data on the comparison of these two sizes of needles in the long-term outcome of physiological and holistic recovery since PDPH greatly influences the postoperative well-being, length of stay, and patient satisfaction.

Methods: It was a prospective randomized clinical trial done in a tertiary care hospital in a period of four months. A randomized study (N=196 obstetric patients that planned to undergo elective Caesarean Section under spinal anesthesia) was performed wherein 25-G Quincke needle (Group A, n=98) and 27-G Quincke needle (Group B, n=98) was administered as the anesthesis. In PDPH presence and severity, a Visual Analogue Scale (VAS) was used to assess both 24 and 48 hours after surgery. Holistic recovery was measured using duration of stay in the hospital, need of further analgesia, and patient satisfaction survey.

Results: The research study indicated that the needle gauge has a major role in the rate and intensity of PDPH. Anaesthetized patients using the smaller 27-G Quincke needle had fewer headaches, lesser analgesic needs and a short hospital stay than the patients who underwent the spinal anesthesia with the 25-G needle.

Conclusions and Recommendations.: The paper concludes that 27-G Quincke spinal needles are characterized by significantly reduced incidence of PDPH, less severe forms of PDPH, reduced postoperative recovery and increased patient satisfaction as compared to 25-G needles in Caesarean Section anesthesia. It is advised that 27-G Quincke needles be used as a priority in routine obstetric spinal anesthesia in the anesthesia departments to increase patient comfort and minimize postoperative morbidity. Ongoing training of the staff and observance of aseptic spinal practice are also recommended to sustain these better results.