Cochrane · systematic review · CD010807
Needle gauge and tip designs for preventing post‐dural puncture headache (PDPH)
Arevalo‐Rodriguez, I, Muñoz, L, Godoy‐Casasbuenas, N, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
AnaesthesiaAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
15
current version
GRADE rated
14
No studies
1
Included studies
NR
No studies 1 · 6.7%Ungraded 0 · 0%Very low 0 · 0%Low 5 · 33.3%Moderate 9 · 60%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Traumatic needles compared to atraumatic needles for prevention of post‐dural puncture headache (PDPH)
Population: patients undergoing lumbar punctures
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Onset of PDPH Traumatic needles vs atraumatic needles | RR 2.14 [1.72, 2.67] | 36 studies · 9378 participants | Moderate Downgraded: risk of bias |
Adverse events: paraesthesia Traumatic needles vs atraumatic needles | RR 0.96 [0.47, 1.96] | 3 studies · 573 participants | Moderate Downgraded: risk of bias |
Adverse events: backache Traumatic needles vs atraumatic needles | RR 0.94 [0.78, 1.13] | 12 studies · 3027 participants | Moderate Downgraded: risk of bias |
Severe PDPH Traumatic needles vs atraumatic needles | RD 0 [0, 0.01] | 24 studies · 6420 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Any headache Traumatic needles vs atraumatic needles | RR 1.35 [1.17, 1.57] | 18 studies · 4104 participants | Moderate Downgraded: risk of bias |
Larger traumatic needles compared to smaller traumatic needles for prevention of post‐dural puncture headache (PDPH)
Population: patients undergoing lumbar punctures with traumatic needles (Quincke, Greene, Hingson Ferguson, Lutz, Brace, Rovenstine, Lemmon)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Onset of PDPH Larger traumatic needles vs smaller traumatic needles | no estimate extracted | 10 studies · 2288 participants | Low Downgraded: risk of bias |
Adverse events: paraesthesia ‐ not reported Larger traumatic needles vs smaller traumatic needles | no estimate extracted | NR | No studies |
Adverse event: backache Larger traumatic needles vs smaller traumatic needles | no estimate extracted | 3 studies · 948 participants | Moderate Downgraded: risk of bias |
Severe PDPH Larger traumatic needles vs smaller traumatic needles | no estimate extracted | 6 studies · 1128 participants | Low Downgraded: risk of bias |
Any headache Larger traumatic needles vs smaller traumatic needles | no estimate extracted | 3 studies · 771 participants | Moderate Downgraded: risk of bias |
Larger atraumatic needles compared to smaller atraumatic needles for prevention of post‐dural puncture headache (PDPH)
Population: patients undergoing lumbar punctures with atraumatic needles (Whitacre, Atraucan, Sprotte, Cappe‐Deutsh, Pajunk, Gertie Marx, Durasafe, Cappe, Deutsch and Eldor)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Onset of PDPH Larger atraumatic needles vs smaller atraumatic needles | no estimate extracted | 13 studies · 3134 participants | Low Downgraded: risk of bias, imprecision |
Adverse events: paraesthesia Larger atraumatic needles vs smaller atraumatic needles | no estimate extracted | 2 studies · 439 participants | Moderate Downgraded: risk of bias |
Adverse events: backache Larger atraumatic needles vs smaller atraumatic needles | no estimate extracted | 4 studies · 526 participants | Moderate Downgraded: risk of bias |
Severe PDPH Larger atraumatic needles vs smaller atraumatic needles | no estimate extracted | 8 studies · 1983 participants | Low Downgraded: risk of bias, imprecision |
Any headache Larger atraumatic needles vs smaller atraumatic needles | no estimate extracted | 7 studies · 1791 participants | Moderate Downgraded: risk of bias |