Use of a 25-gauge Whitacre needle to reduce the incidence of postdural puncture headache.

We studied 200 orthopaedic inpatients (111 males) aged 15-84 yr who received spinal anaesthesia with one of two types of Whitacre spinal needle: 22-gauge or 25-gauge. The incidence of headache, backache, failure of spinal anaesthesia and patient acceptability was investigated using a questionnaire. The incidence of postdural puncture headache (PDPH) was 4% in the 22-gauge group and 2% in the 25-gauge group. The incidence of backache and headache of other origin was similar in both groups. Spinal anaesthesia was carried out successfully in all patients in both groups. Patient acceptance was high (98%) and there were no serious complications observed. We conclude that spinal anaesthesia is easy to perform with a 25-gauge pencil-point needle and is associated with a low incidence of PDPH.