It is best to
have an assistant available to comfort the patient and help
manage anesthetics and receive and label the test tubes of CSF obtained
from the patient.
The necessary
sterile equipment is often preassembled in an LP kit in the
hospital setting.
| Standard
LP equipment |
|
- Mask, gloves (& gown)
- Prep
solution
- Small
basin
- 4
X 4 gauze sponges
- Sponge
forceps
- Sterile
towels
|
- Local anesthetic
- 25
gauge 5/8" and 22 gauge 1.5" needles
- Spinal
needle
- Four
or five sterile test tubes with stoppers
(Manometer and 3-way stopcock) |
A
variety of LP needle types and sizes are available. A commonly
used needle is a 22 gauge-3 inch LP cutting needle but some clinicians
recommend a 25 gauge and this can be used in the child also.
The size and type of needle used for the LP is known to significantly
affect the incidence of "post-LP headache" - postural
headache - after a diagnostic LP. It occurs as much as in 50% of
patients when a 20 gauge needle is used, and probably in 20- 30%
after punctures with a narrower 22 gauge needle.
 |
 Atraumatic
or non-cutting blunt LP needles will likely reduce
the risk of post-LP headache significantly but
are somewhat more difficult to use.
|
|
Information
related to the choice of needle type can be found at the following
Internet links:
- Atraumatic
vs. Standard Needles for Diagnostic Lumbar Puncture. Thomas
SR, et al. Randomised controlled trial of atraumatic versus
standard needles for diagnostic lumbar puncture. BMJ October
2000;321:986-90
http://www.aafp.org/afp/20010501/tips/6.html
- Assessment:
Prevention of post-lumbar puncture headaches
Report of the Therapeutics and Technology Assessment Subcommittee
of the American Academy of Neurology. Randolph W. Evans, MD;
Carmel Armon, MD, MHS; Elliot M. Frohman, MD, PhD; and Douglas
S. Goodin, MD Neurology 2000;55:909-914
http://www.aan.com/professionals/practice/pdfs/gl0024.pdf
|
 |
