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Needle Size Not Tied to Postdural Puncture Headache in Orthopedic Patients

Among 3,980 patients receiving spinal injections with 22-gauge Quincke cutting needle or 25-gauge pencil-point needle, none developed PDPH

TUESDAY, May 25, 2021 (HealthDay News) — No cases of postdural puncture headache (PDPH) were reported in a cohort of patients receiving spinal injections with smaller or larger needles for spinal anesthesia during orthopedic procedures, according to a study presented at the annual Regional Anesthesiology and Acute Pain Medicine Meeting, held from May 13 to 15 in Lake Buena Vista, Florida.

Andrew Wong, M.D., from Duke University Medical Center in Durham, North Carolina, and colleagues conducted a retrospective chart review to examine PDPH incidence among patients who received spinal injections for spinal anesthesia during orthopedic procedures. The incidence of PDPH was compared with use of a 22-gauge Quincke cutting needle and a 25-gauge pencil-point needle.

Data were included for 3,980 patients who received spinal injections for orthopedic procedures, ranging in age from 18 to 90 years, with an average body mass index of 29.57 kg/m². The researchers found no reported incidences of PDPH.

“Given the benefits of larger gauge cutting needles in performing successful spinals, these results suggest that practitioners can opt for these needles first, reducing the number of attempts needed for success and minimizing the overall time for the procedure, patient discomfort from multiple attempts, and the waste of smaller non-cutting needles,” the authors said in a statement.

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