Post-dural puncture related complications after diagnostic lumbar puncture, myelography and spinal anaesthesia

Objectives - This study was conducted to investigate complications after dural puncture. Material and methods - A 15 months' prospective observation study of routine clinical practice with dural puncture at a university hospital was conducted. Quincke spinal needles 0.90 to 1.0 mm O.D. (20-19 g) were used for diagnostic lumbar puncture, 0.70 mm O.D. (22 g) for myelography and 0.40 to 0.50 mm O.D. (27-25 g) for spinal anaesthesia. A questionnaire about post-puncture discomfort was given to the patients, to be returned after 1 week. Results - Of 679 questionnaires 537 (79.1%) were returned. Discomfort was experienced by 53.8% of the patients, most often after diagnostic lumbar puncture and myelography. The difference in incidence of headache after diagnostic lumbar puncture and myelography compared with spinal anaesthesia were 27.9% (95 % CI: 18.6 to 37.2) and 18.3% (95% CI: 9.1 to 27.5). Conclusion - Small diameter and atraumatic spinal needles will reduce patients' discomfort after dural puncture.