Introduction: Post dual puncture headache (PDPH)  first described by Augustus Bier in 1898⁴ from his personal experience following a failed attempt of spinal anesthesia  on himself  due to mechanical difficulty. However his Assistant Hildebrandt⁴ successful in this regard in the same year and he also experienced PDPH. Two most important predictors of (PDPH) are type of spinal needle and its size^5,6. In 1951 Hart and Whitacre⁷ reported lower PDPH rates with pencil point needle (Whitacre) than cutting (Quincke) type of needle. Till date, numerous studies demonstrated lower incidence of PDPH following spinal anaesthesia with the use of smaller size spinal needle in comparison to larger one.

Method: The study was a randomized, single blind, non placebo comparative study which includes 130 patients with ASA grade I & II of either sex, between the ages 25 years to 50 years going for lower abdominal surgery. cases was divided randomly into two groups: Group A with 25G and Group B with 27 G Quincke needles. 3.5ml 0.5% Bupivaccine heavy was injected intrathecally at either L₂-L₃ or L₃-L₄ interspace in every patient after computer generated Randomization.

Result: In our study it is observed that the percentage of PDPH in group A  21%  and that of group B  4.6%. Group A & Group B were comparable with regard to age, sex distribution & ASA  grading  so no statistical significant difference were found with regard to these parameters.

Conclusion: It can be concluded from our study, large bore cutting type of spinal needle (25G Quincke), producesmore  PDPH than  small bore cutting type of spinal needle (27G Quincke).

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Dr Chandra Bhushan Kumar

Junior Resident, Department of Anaesthesiology, KMC, Katihar, India