To compare the frequency and severity of post dural puncture headache in obstetric patients using 23G,25G & 27G Quincke spinal needle.

300 ASA I-II full term pregnant women, 20 to 40 years of age, scheduled for LSCS, under spinal anaesthesia, were randomized into three groups: Group I (23G Quincke spinal needle: n=100), Group II(25G Quincke spinal needle: n=100) and Group III (27G Quincke spinal needle: n=100). Subarachnoid block was performed with 2.0-2.2 ml 0.5% hyperbaric bupivacaine at L3-4 inter-vertebral space. Each patient was assessed daily for five consecutive days following caesarean section. Frequency and severity of post dural puncture headache (PDPH) was recorded.

Frequency of PDPH following the use of 23G, 25G and 27G spinal needles was 12% (12/100), 4% (4/100) and 3.15% (3/95) respectively. Headache was graded as mild, moderate & severe.Most of the patients developed PDPH on 3rd& 4th postoperative day

While using 27G & 25G spinal needle, frequency and severity of PDPH was significantly lower than when 23G needle was used while there was no significant difference with 25G & 27G spinal needles. But it was observed that 27G spinal needle was technically more difficult to use that included difficulty in stabilising the needle while injecting the drug, inadequate level of block due to slow injection of the drug through its small gauge & failed spinal while performing the spinal anaesthesia. Therefore, we recommend that incidence of PDPH can be decreased to very low levels by using 25G spinal needle & proper postoperative care of the patient.