1*Final year Post Graduate, Department of Anaesthesiology and Critical Care, Sree Balaji Medical College & Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai - 600044
2Assistant Professor, Department of Anesthesiology and Critical Care, Sree Balaji Medical College & Hospital, Bharath Institute of Higher Education and Research (BIHER). ORCID iD: 0000-0002-6365-4541
3Professor, Department of Anesthesiology and Critical Care, Sree Balaji Medical College & Hospital, Bharath Institute of Higher Education and Research (BIHER). ORCID iD: 0000-0003-3502-9535
4Allied Health Sciences (B.Sc Operation Theatre and Anaesthesia Technology), Sree Balaji Medical College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai – 600044, Tamil Nadu, India
Background: Post-dural puncture headache (PDPH) remains one of the most common complications following spinal anaesthesia, particularly in obstetric and gynaecological patients. The design and gauge of spinal needles significantly influence dural trauma and cerebrospinal fluid leakage, thereby affecting the incidence of PDPH. Atraumatic pencil-point needles such as the Whitacre needle are believed to reduce dural fibre disruption compared with cutting needles like Quincke. This study aimed to compare the incidence and characteristics of PDPH following spinal anaesthesia using 27-gauge Quincke and 27-gauge Whitacre spinal needles.
Methods: A hospital-based comparative cross-sectional study was conducted in the Department of Anaesthesiology at Sree Balaji Medical College and Hospital, Chennai, over a six-month period in 2024. Sixty female patients aged 20–55 years undergoing obstetric or gynaecological surgery under spinal anaesthesia were included. Participants were divided into two groups: Group Q (27G Quincke needle) and Group W (27G Whitacre needle), with 30 patients in each group. The occurrence, location, and severity of PDPH were assessed postoperatively for four days using a structured questionnaire and Visual Analog Scale. Hemodynamic parameters including heart rate and mean arterial pressure were also monitored. Statistical analysis was performed using SPSS software, and a p-value <0.05 was considered statistically significant.
Results: The demographic characteristics were comparable between the groups (mean age: 30.3 ± 7.42 years in Group Q vs 30.2 ± 6.86 years in Group W). The incidence of PDPH was significantly higher in the Quincke group (26.7%) compared with the Whitacre group (13.3%) (p = 0.0229). Occipital headache was the most common presentation, observed in 13.4% of Quincke patients and 6.7% of Whitacre patients. Frontal headache occurred in 10% of Quincke patients and 3.4% of Whitacre patients. Headache severity scores were higher in the Quincke group, particularly on postoperative day four. Hemodynamic parameters remained largely comparable between groups.
Conclusion: The 27-gauge Whitacre spinal needle demonstrated a significantly lower incidence and severity of post-dural puncture headache compared with the 27-gauge Quincke spinal needle. The findings support the preferential use of atraumatic pencil-point needles to reduce PDPH and improve postoperative outcomes in obstetric and gynaecological spinal anaesthesia.
Keywords: Subarachnoid block; Intrathecal anesthesia; Cerebrospinal fluid leakage; Dural puncture complications; Obstetric anesthesia; Visual analog scale
How to cite this article: Megha B, Bhagyavardhan B, Balasubramanian K, Jayashree S. A Cross-Sectional Study On Comparing The Effects Of 27-Gauge Quincke Spinal Needle Versus 27-Gauge Whitacre Spinal Needle On Post Dural Puncture Headache In Obstetrics And Gynecology Patients Undergoing Spinal Anaesthesia. Int J Drug Deliv Technol. 2026;16(2): 152-159; DOI: 10.25258/ijddt.16.2.18
Source of support: Nil.
Conflict of interest: None