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Procedural Steps
Preparation
Patient Positioning
Landmarking
Site Preparation
Local Anesthesia
Needle Insertion
Collection of CSF
Removal of Needle
Post-procedural Care
Interpretation of Results
CSF Pressure
Measurements

Quiz
LP Pressure Quick Guide





Using the 25 gauge needle, create a skin wheal with local anesthetic at the insertion site. Now change to the 22 gauge needle to infiltrate the subcutaneous and interspinous areas. Before injecting anesthetic, draw back the plunger to ensure that the needle has not reached the subarchnoid space, and then gradually withdraw the needle while injecting anesthetic along the path that your LP needle will follow. A volume of 3 cc. of 1% lidocaine solution should be sufficient.

Unless there is an allergy or contraindication to lidocaine, this local anesthetic is most often used. Some authors recommend a few c.c.'s of lidocaine be used. This amount of medication may distort an easily felt spinous process with a "lidocainoma". If the supraspinous ligament is felt easily, you can use just a small amount of lidocaine. Make all of your needle insertions in the midline to avoid confusion.

   

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