Postspinal headache in young and elderly patients. Two randomised, double-blind studies that compare 20- and 25-gauge needles

In two randomised, double-blind studies of elderly patients with a mean age of 68.9 (range 21-88) years and young patients, mean age 29.4 (range 20-40) years, the effect of needle size on the incidence of postspinal headache was compared. The two needle groups, 20- and 25-gauge, were comparable in both studies with regard to number, sex, age and type of surgery. The incidence of postspinal headache in young patients was 27.6% when a 20-gauge needle was used and 12.6% with a 25-gauge needle. There was no significant difference in either the incidence of headache in the elderly patients (10.8% and 7.8%, respectively) or between the sexes. It is concluded that it does not matter if a 20- or a 25-gauge needle is used for spinal analgesia in elderly patients with regard to postspinal headache, but if spinal analgesia is indicated in young patients a fine needle is preferred.