A COMPARISON OF LUMBAR PUNCTURE WITH AND WITHOUT BEDSIDE ULTRASOUND. Issue 12 (15th November 2016)

• Record Type: Journal Article
• Authors: Williams, Stefan; Khalil, Modar; Davey, Richard
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 87:Issue 12(2016)
• Page Start: e1
• Page End: e1
• Publication Date: 2016-11-15
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2016-315106.6
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Background: There is evidence that ultrasound-assisted lumbar puncture (LP) is more effective, and has fewer side effects, than the traditional, palpation based technique. However, neurologists have never published a trial of the method, and the use of ultrasound is not common practice in UK neurology departments. The aim of this study was to compare the efficacy and adverse effects of using ultrasound-assisted versus traditional LP, in a neurology department setting. Methods: Consecutive patients undergoing day case LP were randomly assigned to ultrasound-assisted (n=20), or traditional (n=19) LP. Two neurology registrars, previously trained in ultrasound, performed the procedures. We measured success in obtaining CSF, time to mark, patient-rated discomfort, and side effects, including patient-reported post-LP headache. Results: Ultrasound-assisted lumbar punctures showed a higher rate of success in obtaining CSF (90% vs 74%), and a lower rate of post-LP headache (20% vs 55%), although neither reached statistical significance. Time to mark was longer with ultrasound (166 s vs 30 s, p=0.0001). Discomfort scores were similar between groups. Conclusion: Our experience of bedside ultrasound assisted lumbar puncture is one of a higher success rate and lower post-LP headache rate compared with the traditional technique (although numbers did not reach statistical significance in this small trial).