Background and objectives: Reports have emphasized the importance of spinal needle tip configuration in the development of post dural puncture headache (PDPH).
Methods: Charts from 366 consecutive obstetric patients receiving spinal anesthesia for labor, cesarean delivery, postpartum surgical procedures, or postpartum tubal ligations were reviewed retrospectively for evidence of PDPH in the five days after dural puncture. Spinal anesthesia was administered to these patients using 25-gauge Quincke (n = 74), 26-gauge Quincke (n = 160), or 24-gauge Sprotte (n = 132) spinal needles.
Results: The groups were well matched demographically. The incidence of PDPH in the three groups was 9%, 8%, and 1.5%, respectively. Half of the patients developing PDPH in each group were treated with an epidural blood patch.
Conclusions: Our data indicate that the Sprotte spinal needle, with its non-cutting tip, results in a significantly lower (p less than 0.05) incidence of PDPH than Quincke cutting-tip needles of smaller gauge.