KUMJ | VOL. 1 | NO. 4 | ISSUE 4 | OCT-DEC, 2003

A comparison of 25 gauge Quincke spinal needle with 26 gauge Eldor spinal needle for the elective Caesarian sections: Insertion characteristics and complications
Tabedar S, Maharjan SK, Shrestha BR, Shrestha BM


Abstract:
Objective: The study was designed to compare the insertion characteristics and incidence of PDPH between 25
gauge Quincke needle and 26 gauge Eldor needle for spinal anaesthesia in elective c/s.
Method: 60 pregnant women (aged 19-35yrs and weighing 58 67kg) undergoing elective caesarean section were
randomized into group A (Quincke spinal needle group) or group B (Eldor spinal needle group). Spinal anaesthesia
was performed with 2.9 ml 0.5% heavy bupivacaine using 25 gauge Quincke spinal needle in group A and 26 Gauge
Eldor spinal needle in group B. Onset, time of first identification of backflow of CSF, number of attempts, level of
sensory and motor blockade, failure of anaesthesia, inadequate anaesthesia and incidence of PDPH were recorded.
Result: Quincke spinal needle was found easy at insertion, first attempt was successful in 90% of cases, whereas
Eldor spinal needle was successful at first attempt in only 60% of cases. Early identification of CSF was seen in
Eldor spinal needle group in 3.5 seconds vs. 5.2 seconds in Quincke spinal needle group. Blood mixed CSF was
seen in 8 Quincke spinal needle group vs. none in Eldor spinal needle group. Onset was similar between both groups
i.e. in 6 minutes. Failure of anaesthesia was none in Eldor spinal needle group vs. 2 in quincke spinal needle group.
Height of sensory block achieved was T4 level in 26 parturients,T6 in 1 ,T8 in 1 and no anaesthesia at all in another
2 parturient as compared to T4 level in 29 and T3 in 1 parturient in Eldor spinal needle group. The degree of motor
block with the use of Bromage criteria showed a motor score of 1or 2 in 26 parturients in Quincke spinal needle
group vs. same in all cases in Eldor spinal needle group. The total incidence of PDPH was 8.3 %( 5 out of 60
parturient) which occurred all in Quincke spinal needle group. 2 parturient who developed severe PDPH required
epidural blood patch.
Conclusion: 26 gauge Eldor spinal needle was found to be better than 25 gauge Quincke spinal needle for caesarian
sections to decrease the incidence of PDPH, though not all insertion characteristics were in favour of the Eldor
needle.

Keyword : Anaesthetic technique, spinal; equipment, spinal needles; complications, headache.