Dr. Deepak Sharma, Dr. Sukhreet Kaur, Dr. Parnendu Deo
Aims: The purpose of the study was to evaluate the occurrence of post dural puncture headache with different design spinal needle with respect to issues pertaining to technique or equipment in lower segment caesarean section. Settings and Design: Prospective randomized clinical study. Methods and Material: This study included 268 parturient who were randomized into five groups based on spinal needle used for performing the subarachnoid block and groups were designated as I,II and III where 25G cutting needle was used and IV and V where 25G and 27 G pencil point needle was used respectively. Bevel direction was parallel to longitudinal fibres of dura in group I and II and perpendicular in III. Stylet was replaced in all the groups except I. Response to therapy was adjudged by Corbeys grading score Statistical analysis used: Data was statistically analyzed using SPSS (Version 23.0). For categorical data, Chi-Square test, numerical data for inter group comparison, one way analysis of variance (ANOVA) test and Z test were applied for comparison of proportion between two groups. p- Value of <0.05 was considered statistically significant Results: The occurrence of post dural headache was statistically significant among the groups. Group III was recorded to have the highest 14/55(25%) whereas in sequence group I, II and IV with 10/52(19%), 8/54(15%) and 2/54(4%) followed. There was no occurrence in Group V. The response to conservative therapy was adequate except in two patients with severe headache. Conclusions: Pencil point needles plays a substantial role in decreasing or eliminating PDPH. It would be discreet to substitute them for the cutting type needles. For the cutting needle the stylet should preferably be replaced. The response to therapy can reliably be monitored by Corbeys grading for severity of headache.
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