Objective: To compare the insertion characteristics and rate of complications between 25-gauge Quincke and 24-gauge Gertie Marx needles.
Design: Prospective, randomized study.
Setting: University of Benin Teaching Hospital; a university-affiliated tertiary centre.
Subjects: Parturients (ASA 1 and 2) scheduled for elective caesarean section. They were randomly assigned to receive spinal anaesthesia with either 25-gauge Quincke needle or 24-gauge Gertie Marx needle. The patients with abnormal spaces, coagulopathy, infection, pre-eclampsia/eclampsia or obesity were excluded.
Main outcome measures: The number of attempts at successful identification of the spinal space, intraoperative complications, incidence of postdural puncture headache (PDPH), non-postdural puncture headache (NPDPH) and backache.
Results: Sixty women were studied. The 24-gauge Gertie Marx needle resulted in more successful location of the spinal space on the second attempt (P<0.05). Non-postdural puncture headache was seen in 43% of the study population. PDPH was seen in 10% of the Quincke group and none in the Gertie Marx group. There was no difference in the incidence of backache in both groups.
Conclusion: The ease of insertion and low incidence of PDPH with the Gertie Marx needle may encourage trainee anaesthetists to use this needle for caesarean section.