Does Intrathecal Mepivacaine Cause Post Lumbar Puncture Headache?
Jeffrey S. Lee, MD Women s and Children s Hospital, USC Medical Center, Los Angeles, CA To the Editor: In the article by Meininger, et al. (1), the authors report an incidence of post lumbar puncture headache of nearly 10% (9/100) using a 25-gauge pencil-point needle. This is a more frequent incidence than is usually found with this type of needle and is of the same order of magnitude as used to occur using 25-gauge Quincke needles. The authors do not comment on this nor do they mention how many patients required epidural blood patch for treatment. I wonder if mepivacaine could be the reason for this phenomenon. Reference Meininger D, Byhahn C, Kessler P, et al. Intrathecal fentanyl, sufentanil, or placebo combined with hyperbaric mepivacaine 2% for parturients undergoing elective cesarean delivery. Anesth Analg 2003; 96: 852 8.
