Comparison of two 27-G-caliber needles for spinal anesthesia. Study of 1,555 patients

OBJECTIVES: The purpose of this study was to compare two 27-gauge anesthesia needles with different points (a Whitacre-type point and a Quincke-type point) and to assess the incidences of postdural puncture headache (PDPH), puncture difficulty and failed anesthesia. MATERIAL AND METHODS: This prospective, randomized and double-blind trial enrolled 1,555 patients receiving spinal anesthesia for lower abdominal surgery. No age limits were established. A 27-gauge Whitacre-point needle was used in group I (n = 748) and a 27-gauge Quincke-point needle was used in group II (n = 774). RESULTS: The incidences of PDPH were significantly different in groups I (0.53%) and II (1.85%) (p < 0.01). Puncture was easy in 84.89% of the procedures in group I and in 78.81% in group II (p < 0.01). The number of cases in which a puncture could not be accomplished was similar in the two groups (2.41% in group I and 2.07% in group II). The number of failed anesthetic procedures was also similar (0.96% in group I and 1.45% in group II). CONCLUSIONS: When a 27-gauge Whitacre-point needle is used, fewer cases of PDPH develop and the puncture is easier to accomplish than when a Quincke-point needle is used. The number of failed anesthetic procedures is similar with both needles. Whitacre-point 27-gauge needles are preferable to Quincke-point 27-gauge needles.