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A protocol to reduce self-reported pain scores and adverse events following lumbar punctures in older adults
- Source :
- J Neurol
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- 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 25g needle. METHODS: 809 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.
- Subjects :
- Male
medicine.medical_specialty
Neurology
Nausea
Pain, Procedural
Spinal Puncture
Article
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Lumbar
Clinical Protocols
Internal medicine
medicine
Back pain
Humans
030212 general & internal medicine
Adverse effect
Aged
Pain, Postoperative
medicine.diagnostic_test
Lumbar puncture
business.industry
Middle Aged
Outcome and Process Assessment, Health Care
Female
Self Report
Neurology (clinical)
Headaches
medicine.symptom
business
Low Back Pain
030217 neurology & neurosurgery
Cohort study
Subjects
Details
- ISSN :
- 14321459 and 03405354
- Volume :
- 267
- Database :
- OpenAIRE
- Journal :
- Journal of Neurology
- Accession number :
- edsair.doi.dedup.....eb5fe8ded53e7c32c5e4b215688d1c6b