The Usefulness of Ultrasound-assisted Lumbar Puncture on Adult Patients in the Emergency Center: Comparison with Classic Lumbar Puncture

Lee, Won Suk; Jeong, Won Joon; Yi, Hwa Yeon; Ryu, Seung; Lee, Jin Woong; Kim, Seung Whan; Yoo, In Sool; You, Yeon Ho

Abstract

PURPOSE: To evaluate the utility of ultrasound-assisted lumbar puncture in the emergency department.
METHODS
This was a prospective randomized controlled trial. We enrolled patients who were 18 years of age or older from May to August 2007. Patients were divided into a classic lumbar puncture group (group A) and an ultrasoundassisted lumbar puncture group (group B). We compared the frequency of attempting the procedure, the procedure time, the failure rate of lumbar puncture, and the traumatic lumbar puncture between groups.
RESULTS
Sixty-one patients were enrolled in the study. Thirty-two patients were in group A and 29 patients were in group B. There were 6 cases of failed lumbar puncture in group A and one case in group B (p=0.07), and there were 3 cases of traumatic lumbar puncture in group A, and one case in group B (p=0.35). It took 8.6+/-8.4 minutes to accomplish lumbar puncture in group A compared to 8.2+/-6.4 minutes in group B (p=0.85). Overall, the frequency of attempting the procedure was 2.3+/-1.8 in group A and, 1.6 +/-1.1 in group B (p=0.66). In elderly patients (age> or =60 years) the frequency of attempting the procedure was 4.0+/-2.5 in group A and 1.6+/-0.5 in group B (p=0.03). There were 4 cases of failed lumbar puncture in group A but none in group B.
CONCLUSION
Emergency physicians did not generally attempt ultrasound-assisted lumbar puncture in the emergency department. For elderly patients(> or =60 years), however, it was an available tool for emergency physicians and employed more frequently.