The Effect of Configuration of the Needle on the Postspinal Headache in Young Males of the Third Decade / 대한마취과학회지

The incidence of postspinal headache is one of the well known complications of spinal anesthesia. The development of postspinal headache is related to age and sex of patients, size and configuration of the needle, pregnancy, direction of needle bevel, number of dural puncture. I studied the effect of configuration and size of the needle (22 gauge 25 gauge Quinke needle and 22 gauge,25 gauge Whitacre needle ) on the incidence, onset, duration and severity of postspinal headache in the 200 males of the third decade after spinal anesthesia. The following results were observed: 1) The incidence of postspinal headache in 22 gauge, 25 gauge Whitacre needle groups(4%. 2%) is lower than that of 22 gauge, 25 gauge Quinke needle groups(10%, 8%). 2) The severity of headache was mild and moderate level in 7 cases, severe level in 2 cases of all the 9 cases with postspinal headache of Quinke needle groups but mild and moderate level in 3cases of all the 3 cases with postspinal headache of Whitacre needle groups. 3) The onset of headache was within 24 hours in 55.6% in Quinke needle groups, 100% in Whitacre needle groups and the duration of headache was within 5 days in 77.8% in Quinke needle groups, 100% in Whitacre needle groups postoperatively. 4) The sites of headache were 55.6% in frontal, 33.3% in occipital region in Quinke needle groups and 66.7% in frontal, 33.3% in occipital region in Whitacre needle groups. In conclusion, the headaches which occur following use of Whitacre needle have been lower in and of less severity than those seen after use of Quinke needle in young males of the third decade.

Effect of Needle Bevel Direction on the Postspinal Headache in Young Males of the Third Age Decade / 대한마취과학회지

The incidence of postspinal headache is one of the well known complications of spinal anesthesia. The development of postspinal headache is related to age and sex of patients, needle size, needle configuration, pregnancy, direction of needle bevel, number of dural puncture. This study was done to see the effect of various gauge Quincke needles(22, 23, 24, 25, 26gauge) and needle bevel direction on the incidence, severity, onset and location of postspinal headache in the 200 male patients of the third age decade undergoing spinal anesthesia. There were one group consisting of 100 patients who underwent parallel insertion to longitudinal dural fibers and the other group consisting of 100 patients who underwent vertical. Each group consisting of 100 patients had five subgroups with 20 patients in related to each needle gauge. A system of criteria for registering postspinal headache and its severity is proposed. The following results were observed: 1) The incidence of postspinal headache was 10% in one group who underwent parallel insertion to longitudinal dural fibers but 27% in the other group who underwent vertical. 2) The severity of headache was mild level in all the 10 cases with postspinal headache of parallel insertion group but above moderate level in 14 cases of all the 27 cases with postspinal headache of vertical insertion group. 3) The small size of needle had a trend with lower incidence of postspinal headache than the large size . 4) The onset of postspinal headache was within 3 day after spinal anesthesia in the almost patients(92.5%) with postspinal headache. 6) The sites of postspinal headache were 59.5% in frontal, 18.9% in occipital, 16.2% in generalized, 5.4% in parietal region. In conclusion, the method of insertion parallel to longitudinal dural fibers is significantly lower incidence of postspinal headache than that of insertion vertical to longitudinal dural fibers in young males of the third age decade.

Effects of Needle Size and Needle Bevel Direction on the Postspinal Headache / 대한마취과학회지

The incidence of postspinal headache is one of the well known complications of spinal anesthesia. Several factors such as needle size, bevel direction, multiple dural puncture and previous history of postspinal headache were thought to influence the incidence of postspinal headache. This studies were done to see the effect of needle size (22 and 25 gauge needle) and needle bevel direction (parallel, vertical, oblique insertion to the longitudinal dural fiber) on the incidence, duration, severity and location of spinal headache in the 548 patients underwent spinal anesthesia. The following results wre observed: 1) Neither needle size nor needle bevel direction had effect on the incidence of severity, duration and location of postspinal headache. 2) The ineidence of headache was 8.8% (48 cases), 3) The onset of headache was 1~2 day (67%) and duration of headache was 4~5 day (85%) in postanesthetic day. 4) The severity of headache was mild and moderate in 77% cases. 5) In the half cases, headache was relieved by means of bed rest alone.

Postspinal Headache and It's Treatment / 대한마취과학회지

Postlumbar puncture headache is a common complication of spinal anesthesia. It usually may be alleviated by adequate hydration, continuous recumbency, abdominal compression and analgesic medication. However, these conservative treatments are only symptomatic and epidural blood patch is curable approach based on pathophysiology. During the 3 year period from 1988 to 1990, 700 cases of spinal anesthesia were recorded by Wonju Christian Hospital, Wonju Medical College, Yonsei University. This study was primarily undertaken to observe several aspects of postspinal headache i.e. incidence, age and sex distribution, onset, duration and treatment. The results were as follows: 1) The overall incidence of headache was 10.6% (74 cases). 2) Headache occurred in highest frequency in patients in the third and fourth decades. 3) Frequency of headache was higher in women. 4) The onset of headache was within postop. 3 days. 5) The duration of headache was within 6 days. 6) a) 12 cases were cured spontaneously. b) 52 cases were cured by conservative treatment. c) 10 cases were cured by the epidural blood patch.