Complications with 25-gauge and 27-gauge whitacre needles during combined spinal-epidural analgesia in labor

R. Landau, C. F. Ciliberto, S. R. Goodman, S. H. Kim-Lo, R. M. Smiley

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


Needle size and shape may influence the incidence of paresthesias, post-dural puncture headache and other complications during combined spinal-epidural (CSE) procedures. We have noted a relatively high incidence of transient paresthesias during placement of the spinal needle during CSE for labor analgesia. The purpose of this study was to compare the occurrence of paresthesia and post-dural puncture headache in parturients who received CSE analgesia with either a 25-gauge or 27-gauge Whitacre needle. In a prospective observational study, data were gathered from 478 consecutive women receiving labor analgesia. Incidence, duration, and character of any paresthesias upon spinal needle placement and the incidence and treatment of headache were recorded. The incidence of paresthesia with the two needles was similar (16% with 25-gauge vs15.4% with 27 gauge) but the incidence of post-dural puncture headache was higher with the 25-gauge needle (4% vs 0.7% with 27 gauge, P < 0.05). Our data suggest that with Whitacre needles, 27-gauge might be preferable to 25-gauge needles to reduce the rate of post-dural puncture headache in parturients but that they do not alter the incidence of transient paresthesias.

Original languageEnglish (US)
Pages (from-to)168-171
Number of pages4
JournalInternational Journal of Obstetric Anesthesia
Issue number3
StatePublished - Jan 1 2001

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Anesthesiology and Pain Medicine


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