A protocol to reduce self-reported pain scores and adverse events following lumbar punctures in older adults.
Journal Article (Clinical Trial;Journal Article)
OBJECTIVE: Lumbar punctures (LPs) are important for obtaining CSF in neurology studies but are associated with adverse events and feared by many patients. We determined adverse event rates and pain scores in patients prospectively enrolled in two cohort studies who underwent LPs using a standardized protocol and 25 g needle. METHODS: Eight hundred and nine LPs performed in 262 patients age ≥ 60 years in the MADCO-PC and INTUIT studies were analyzed. Medical records were monitored for LP-related adverse events, and patients were queried about subjective complaints. We analyzed adverse event rates, including headaches and pain scores. RESULTS: There were 22 adverse events among 809 LPs performed, a rate of 2.72% (95% CI 1.71-4.09%). Patient hospital stay did not increase due to adverse events. Four patients (0.49%) developed a post-lumbar puncture headache (PLPH). Twelve patients (1.48%) developed nausea, vasovagal responses, or headaches that did not meet PLPH criteria. Six patients (0.74%) reported lower back pain at the LP site not associated with muscular weakness or paresthesia. The median pain score was 1 [0, 3]; the mode was 0 out of 10. CONCLUSIONS: The LP protocol described herein may reduce adverse event rates and improve patient comfort in future studies.
Full Text
Duke Authors
- Amundsen, Cindy Louise
- Berger, Miles
- Blazer III, Dan German
- Bolognesi, Michael Paul
- Brigman, Brian Eugene
- Browndyke, Jeffrey Nicholas
- Bullock, William Michael
- Cohen, Harvey Jay
- Colin, Brian Joseph
- Devinney, Michael
- Erdmann, Detlev
- Esclamado, Ramon Mitra
- Gadsden, Jeffrey Charles
- Gupta, Dhanesh Kumar
- Habib, Ashraf Samir
- Harpole Jr., David Harold
- Hartwig, Matthew
- Iboaya, Ehimemen
- Inman, Brant Allen
- Lagoo-Deenadayalan, Sandhya Anand
- Lipkin, Michael Eric
- Mantyh, Christopher Ritchie
- Mathew, Joseph P.
- Migaly, John
- Mithani, Suhail Kamrudin
- Moretti, Eugene William
- Mosca, Paul Joseph
- Moul, Judd Wendell
- Murdoch, David Martin
- Newman, Mark Franklin
- Onaitis, Mark William
- Peterson, Andrew Charles
- Polascik, Thomas James
- Robertson, Cary Nobles
- Runyon, Scott Lawrence
- Scales Jr., Charles Douglas
- Scheri, Randall Paul
- Stang, Michael Tracey
- Tong, Betty Caroline
- Vaslef, Steven Nicholas
- Wellman, Samuel S.
- Whitson, Heather Elizabeth
- Wickenheisser, Victoria
- Young, Christopher Carlo
Cited Authors
- Nobuhara, CK; Bullock, WM; Bunning, T; Colin, B; Cooter, M; Devinney, MJ; Ferrandino, MN; Gadsden, J; Garrigues, G; Habib, AS; Moretti, E; Moul, J; Ohlendorf, B; Sandler, A; Scheri, R; Sharma, B; Thomas, JP; Young, C; Mathew, JP; Berger, M; MADCO-PC and INTUIT Investigators Teams,
Published Date
- July 2020
Published In
Volume / Issue
- 267 / 7
Start / End Page
- 2002 - 2006
PubMed ID
- 32198714
Pubmed Central ID
- PMC7336280
Electronic International Standard Serial Number (EISSN)
- 1432-1459
Digital Object Identifier (DOI)
- 10.1007/s00415-020-09797-1
Language
- eng
Conference Location
- Germany