Post-dural puncture headache in young adults: comparison of two small-gauge spinal catheters with different needle design

Background. To reduce the risk of post-dural puncture headache(PDPH) in continuous spinal anaesthesia, small-gauge spinalcatheter systems with different techniques of dural perforationhave been developed. Methods. Two systems, the catheter through-needle technique(MicroCatheter, Portex, UK) and the catheter over-needle technique(22G Spinocath®, B. Braun, Germany), were used in 18 younghealthy volunteers (age 18–30 yr), who were enrolled ina neuroendocrinological investigation for analysis of neuropeptidesin cerebrospinal fluid (CSF). After intermittent sampling ofCSF (17x0.5 ml over 4 h), the catheter was removed and the developmentof PDPH and pain intensity were documented prospectively bythe subjects in a standardized headache assessment (11-pointnumerical rating scale [NRS]). Results. The study revealed a high overall incidence of PDPH(78%) with no significant differences between groups (P=0.26).However, the over-needle group showed a significantly shorterduration of PDPH (2.4 [SD 2.3] vs 5.1 [3.1] days, P=0.050) andlower maximum pain intensity (3.1 [2.9] vs 7.3 [3.4] NRS, P=0.014)than the through-needle group. Conclusions. The results demonstrate a potential benefit ofthe catheter over-needle technique for the reduction of theduration and intensity of PDPH.