Which needle design feature reduces the incidence of post-dural puncture headache after spinal anaesthesia?
- A Pencil-point tip design that spreads rather than cuts dural fibres ✓
- B Larger gauge cutting bevel such as 22G Quincke
- C Introducer needle use irrespective of spinal needle type
- D Paramedian approach with any needle type
Correct answer: A. Pencil-point tip design that spreads rather than cuts dural fibres
Explanation
Pencil-point needles such as the Whitacre and Sprotte separate dural fibres instead of cutting them, leaving a smaller defect that reseals quickly, and they reduce PDPH incidence compared with cutting-bevel Quincke needles of the same gauge. Smaller gauge also lowers risk, so a 25G or 27G pencil-point needle is ideal. An introducer mainly prevents needle bending, and the paramedian approach offers no consistent advantage in young patients. These principles underpin the choice of atraumatic needles in obstetric spinal anaesthesia.
Reference: Miller's Anesthesia, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.