Spinal anaesthesia: needle design and headache: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Spinal anaesthesia: needle design and headache

Sample item

Which needle is associated with the lowest risk of post-dural puncture headache?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. 25 to 27 G pencil-point (Whitacre or Sprotte)

Pencil-point needles spread the dural fibres rather than cutting them and give a smaller dural defect, so headache incidence falls to below 1 to 2%. Large cutting needles, young age and female sex increase risk.

Option by option

  • A. 22 G Quincke cutting needle

    A 22 G cutting needle has a higher risk.

  • B. 18 G Tuohy needle

    A Tuohy needle puncture is associated with about 70% headache.

  • C. 25 to 27 G pencil-point (Whitacre or Sprotte) (correct)

    Correct. Narrow pencil-point needles have the lowest headache risk.

  • D. 20 G Quincke needle

    A 20 G cutting needle has a high risk.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is C, 25 to 27 G pencil-point (Whitacre or Sprotte). Pencil-point needles spread the dural fibres rather than cutting them and give a smaller dural defect, so headache incidence falls to below 1 to 2%.

Why is "22 G Quincke cutting needle" not the answer?

A 22 G cutting needle has a higher risk.

Why is "18 G Tuohy needle" not the answer?

A Tuohy needle puncture is associated with about 70% headache.

Why is "20 G Quincke needle" not the answer?

A 20 G cutting needle has a high risk.

What concept does this question test?

It tests Spinal anaesthesia: needle design and headache in Anaesthesia. Large cutting needles, young age and female sex increase risk.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Spinal anaesthesia: needle design and headache?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.