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Randomized Controlled Trial Comparative Study Clinical Trial
The frequency of postdural puncture headache in obstetric patients: a prospective study comparing the 24-gauge versus the 22-gauge Sprotte needle.
- D H Sears, M I Leeman, L J Jassy, L A O'Donnell, S G Allen, and L S Reisner.
- Department of Anesthesiology, Mercy Hospital and Medical Center, San Diego, CA 92103.
- J Clin Anesth. 1994 Jan 1;6(1):42-6.
Study ObjectiveTo compare the frequency of postdural puncture headache (PDPH) in obstetric patients when using the 24-gauge or the larger 22-gauge Sprotte needle.DesignProspective, randomized study.SettingFour hospitals.Patients375 ASA physical status I and II cesarean section and postpartum tubal ligation patients.InterventionsObstetric patients were randomly assigned to receive spinal anesthesia via a midline dural puncture using the 24-gauge or the 22-gauge Sprotte needle.Measurements And Main ResultsThe rate of PDPH was determined by a postoperative visit by the anesthesiologist as well as questioning patients by telephone 1 week or more after discharge. In the 24-gauge Sprotte needle group (n = 186), 2 mild and 1 moderate PDPHs were reported, for an overall rate of 1.61%. In the 22-gauge Sprotte needle group (n = 189), 2 mild and 1 moderate PDPHs were reported, for an overall rate of 1.59%. All headaches except 1 resolved within 72 hours with conservative treatment. One patient from the 22-gauge Sprotte needle group required an epidural blood patch. There were no failed blocks in either group.ConclusionsOur results suggest that the 22-gauge Sprotte needle, when compared with the smaller 24-gauge Sprotte needle, can be used in obstetric patients without increasing the frequency of PDPH.
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