Eckstein K L, Rogacev Z, Vicente-Eckstein A, Grahovac Z
Reg Anaesth. 1982 Jul;5(3):57-61.
1.009 patients (less than 51 years) were investigated for the frequency of postspinal headaches developing when using different types of needles (22 G and 25 G with Quincke-cut and 22 G Whitacre-needle). It was shown, as expected, that puncture with the smaller needles caused with 6% only about half as many headaches as did taps with the two bigger types of needles, which did not demonstrate any statistical difference between each other. After classifying the complaints as doubtful and definite postspinal headaches the rates of real headaches of the total series was about 5%. The highest frequency of complaints was reported by female patients in the 5th decade. An increase with lesser age was not noticed. Technical difficulties associated with spinal puncture were of almost no importance in influencing the rate of headaches. Definite bloody taps were associated with significantly higher complaint rates. The drugs used (mepivacaine and bupivacaine) did not appear to have any influence. An advantage of the more expensive Whitacre-needle is not seen except in patients with disturbances of coagulation factors.
对1009名年龄小于51岁的患者进行了调查，研究使用不同类型的针（22G和25G的Quincke切口针以及22G的Whitacre针）时发生脊髓穿刺后头痛的频率。正如预期的那样，结果显示，使用较细的针穿刺引起的头痛发生率仅为6%，约为使用两种较大型号针穿刺引起头痛发生率的一半，而这两种较大型号的针之间在头痛发生率上没有显示出任何统计学差异。将主诉分为可疑和明确的脊髓穿刺后头痛后，整个系列中真正头痛的发生率约为5%。报告主诉频率最高的是50多岁的女性患者。未发现随着年龄减小而增加的情况。与脊髓穿刺相关的技术困难对头痛发生率的影响几乎可以忽略不计。明确的血性穿刺与明显更高的主诉率相关。所使用的药物（甲哌卡因和布比卡因）似乎没有任何影响。除了凝血因子有障碍的患者外，未发现更昂贵的Whitacre针有任何优势。
