A Comparative Study of 27g Quincke And 27g Whitacre Spinal Needle on the Incidence of Post Dural Puncture Headache Following Spinal Anaesthesia in Elective Caesarean Section in a Tertiary Care Hospital, Chengalpattu District – A Randomized Controlled Tria

Abstract

women and infants, and minimal systemic drug exposure. Despite these advantages, Post Dural Puncture Headache is a significant side effect, particularly for obstetric patients.The design and gauge of the spinal needle are pivotal factors influencing PDPH incidence.

Objective: To conduct a comparative evaluation of 27G Quincke (cutting-tip) and 27G Whitacre (a traumatic, pencil-point) spinal needles in parturients undergoing elective cesarean section, with a focus on the incidence, severity, and clinical presentation of PDPH, as well as procedural success and complications.

Methods: A prospective, randomised, double-blind clinical experiment planned 120 ASA I-II parturient elective caesarean births. The use of a Quincke or Whitacre 27G needle for spinal anaesthesia was randomly allocated to the participants. Demographic information, PDPH incidence and severity, number of tries, time to CSF flow, unsuccessful blocks, start and duration of symptoms, and related factors were all documented. We used suitable tests to statistically analyse the data, and we regarded a p-value less than 0.05 to be significant.

Results: Demographic similarities ensured baseline homogeneity in both groups. With a p-value of just 0.04 for PDPH, the Whitacre group had a far lower incidence of 3.3% than the Quincke group (10.0%). Whitacre showed less PDPH length, less intensity, and fewer related symptoms, while both needle types had good procedural success rates. Time to CSF detection and number of attempts were similar between groups, indicating no compromise in procedural efficiency.

Conclusion: The 27G Whitacre needle offers a clear clinical advantage over the Quincke design in reducing PDPH and its associated morbidity without sacrificing procedural efficacy. These findings strongly advocate for the routine use of a traumatic pencil-point needles in obstetric anaesthesia to improve postpartum recovery, maternal satisfaction, and overall anaesthetic outcomes.