Mayer D C, Quance D, Weeks S K
Department of Anaesthesia, McGill University, Montreal, Quebec, Canada.
Anesth Analg. 1992 Sep;75(3):377-80. doi: 10.1213/00000539-199209000-00010.
A high incidence of postdural puncture headache (PDPH) occurs after spinal anesthesia for cesarean section. To examine this problem, a study was conducted with the recently developed 24-gauge Sprotte and 27-gauge Quincke needles in patients undergoing elective and emergency cesarean section (n = 298). The needle to be used was assigned in a random manner: group I, 27-gauge Quincke (n = 147); group II, 24-gauge Sprotte (n = 151). During the postoperative period, patients were visited daily and asked specifically about the presence and severity of headache. The overall incidence of PDPH was 2% (n = 6), five in the Quincke group (3.5%) and one in the Sprotte group (0.7%). There was no significant difference in the incidence of PDPH between the two groups. Five headaches were classified as mild, and only one was moderate to severe. All headaches resolved quickly with conservative management and without blood patch. The authors conclude that the choice between a 27-gauge Quincke and a 24-gauge Sprotte needle does not influence the incidence of PDPH after spinal anesthesia for cesarean section.
剖宫产脊髓麻醉后发生硬膜穿刺后头痛（PDPH）的发生率较高。为研究这一问题，对298例行择期和急诊剖宫产的患者使用最近研发的24号Sprotte针和27号Quincke针进行了一项研究。所用针以随机方式分配：第一组，27号Quincke针（n = 147）；第二组，24号Sprotte针（n = 151）。术后期间，每天对患者进行访视，并专门询问头痛的有无及严重程度。PDPH的总体发生率为2%（n = 6），Quincke组有5例（3.5%），Sprotte组有1例（0.7%）。两组之间PDPH的发生率无显著差异。5例头痛被归类为轻度，只有1例为中度至重度。所有头痛经保守治疗后迅速缓解，无需进行血补丁治疗。作者得出结论，27号Quincke针和24号Sprotte针的选择不影响剖宫产脊髓麻醉后PDPH的发生率。
