CLASSIFICATION AND SEVERITY OF POSTDURAL PUNCTURE HEADACHE - COMPARISON OF 26-GAUGE AND 27-GAUGE QUINCKE NEEDLE FOR SPINAL-ANESTHESIA IN DAY-CARE SURGERY IN PATIENTS UNDER 45 YEARS

Two hundred and five patients, aged 16–45 years, undergoing day care surgery were given a spinal anaesthetic using either a 26‐or a 27‐gauge Quincke point spinal needle. The occurrence of headache and accompanying symptoms postoperatively was analysed from 186 returned questionnaires. The incidence of classical postdural puncture headache was 4.5% following the use of a 26‐gauge needle and 8% with a 27‐gauge needle (p > 0.05). A further group of patients suffering headache after dural puncture was identified, the postdural puncture‐related headache. The headache and accompanying symptoms were similar to that seen with a postdural puncture headache except that it was not aggravated by posture. A system of grading the severity of both type of headache is presented and standardised criteria for the classification of postdural puncture headache are proposed. Copyright © 1993, Wiley Blackwell. All rights reserved