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Whitacre or Quincke needles--does it really matter
A L Eriksson1, B Hallén, M Lagerkranser
1Department of Anaesthesiology and Intensive Care, Karolinska Hospital, Stockholm, Sweden.
Insights
The Whitacre needle is more reliable than the Quincke needle for spinal anesthesia, reducing complications like postdural puncture headache (PDPH) and backache, especially in younger patients.
Area of Science:
- Anesthesiology
- Neurosurgery
- Pain Management
Background:
- Postdural puncture headache (PDPH) and backache are common complications following spinal anesthesia.
- The incidence of PDPH is notably higher in younger patient populations (<50 years).
Purpose of the Study:
- To compare the clinical utility and complication rates of Whitacre and Quincke spinal needles.
- To evaluate needle performance in reducing PDPH and backache incidence.
Main Methods:
- A quality control study involving 2598 patients undergoing spinal anesthesia over three years.
- Data collected via questionnaires and detailed anesthetic records from ~50 anesthesiologists.
- Focus on 25 G gauge needles, used in over 90% of cases.
Main Results:
- The Whitacre needle group showed significantly fewer multiple skin punctures compared to the Quincke group (P < 0.01).
- Higher rates of insufficient blocks and backache were observed with Quincke needles (P < 0.01 and P < 0.05, respectively).
- PDPH was more frequent with Quincke needles in patients under 50 years (P < 0.05).
Conclusions:
- The Whitacre needle demonstrates superior performance and reliability for routine spinal anesthesia.
- Utilizing the Whitacre needle in younger patients significantly decreases the risk of postdural puncture headache.
Background:
Postdural puncture headache (PDPH) and backache are well known complications of spinal anaesthesia. The incidence of PDPH may be significant in young people (< 50 years). The present study was undertaken in order to compare the utility and complication rate of the Whitacre and Ouincke spinal needles.
Methods:
During three years all patients who could comply, and who were to undergo spinal anaesthesia at the Department were asked to join this quality control study. Each one received a questionnaire including questions about discomfort and other possible side effects attributed to spinal anaesthesia. In each case, an extended anaesthetic record was filled out by the anaesthesiologist. About 50 anaesthesiologists at different educational levels were involved.
Results:
The study includes 2598 cases, of which questionnaires were returned by 66%. Needles of the 25 G gauge size were used in over 90% of the cases. Multiple skin punctures were required more frequently in the Quincke than in the Whitacre group (P < 0.01). The number of insufficient blocks was also higher in the Quincke group (P < 0.01). There was a higher incidence of backache in the Quincke group (P < 0.05). In patients under 50 years, PDPH was more frequent following use of the Quincke needle (P < 0.05), whereas no difference between the needles in this regard was found among those over 50 years (P > 0.05).
Conclusions:
For routine clinical use the Whitacre needle appears to be associated with better performance and increased reliability. In younger patients the Whitacre needle have the additional advantage of decreasing the risk of postdural puncture headache.
