Postdural puncture headache after neuraxial labor analgesia with 25- vs. 27-gauge Whitacre needles: a single-center retrospective cohort study (2018–2023)
Authors' conclusion
There was a small but statistically significant increase in the incidence of postdural puncture headache when comparing rates with use of 25G vs. 27G needles during CSE or DPE.
Study context
- Population
- Parturients receiving combined spinal epidural (CSE) or dural puncture epidural (DPE) for neuraxial labor analgesia, 2018–2023CSE and DPE procedures
- Participants
- 10,459 participants
- Exposure
- 25G vs 27G Whitacre spinal needles for CSE or DPE
- Outcome
- PDPH rate with intended (not unintended) dural puncture
Methodological detailssingle-center
- Single-center
Main finding
PDPH
Relative risk
0.56
95% CI 0.34–0.92
P = 0.029
By group
25G vs 27G
RR 0.56 (95% CI 0.34–0.92); P = 0.029
As reported in the abstract
Observational data: associations, not effects.
Further findings
Overall PDPH (without unintended dural puncture)
- Patients with PDPH, all procedures
- 54 (0.52%)
Needle use
- CSE most commonly performed
- 91%
- 27G needle used for CSE
- 69%
- 25G needle used for DPE
- nearly two-thirds
Original publication
Postdural puncture headache after neuraxial labor analgesia with 25- vs. 27-gauge Whitacre needles: a single-center retrospective cohort study (2018–2023). Int J Obstet Anesth. Published 10 January 2026. doi:10.
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