Document Detail

Headache after lumbar puncture: randomised crossover trial of 22-gauge versus 25-gauge needles.
MedLine Citation:
PMID:  24233069     Owner:  NLM     Status:  Publisher    
OBJECTIVES: To compare the frequency of headache and the procedure time following lumbar puncture (LP) using a 25-gauge needle compared to a 22-gauge needle.
DESIGN: 4-period crossover blinded randomised controlled trial.
SETTING: Oncology unit, Royal Children's Hospital, Melbourne.
PATIENTS: Children aged 4-15 years at enrolment having LPs as part of their treatment for leukaemia.
INTERVENTIONS: Each child was allocated a random sequence of four LPs, two with a 22-gauge and two with a 25-gauge needle.
OUTCOME MEASURES: The presence of post-LP headache. Secondary outcomes included the presence of any headache, procedure time and impact of headache on the family.
RESULTS: Data on 341 procedures in 93 randomised children were analysed. There was little difference in the incidence of post-LP headache between the two needle sizes (22-gauge 7.2%, 95% CI 3.8 to 12.2; 25-gauge 4.6%, 95% CI 2.0 to 8.9, p=0.3) or in the incidence of any headache (22-gauge 18% 95% CI 12.5 to 24.6; 25-gauge 15%, 95% CI 10.0 to 21.1, p=0.4). Use of the 25-gauge needle was associated with longer procedure times. The incidence of post-LP headache showed little evidence of an age effect (OR =1.1, 95% CI 0.98 to 1.3) and was higher in girls than in boys (11% vs 3%, respectively, OR=3.3, 95% CI 1.3 to 8.4, p=0.014). Fifty-five per cent of families with a child with a post-LP headache assessed the overall functional impact as moderate or severe.
CONCLUSIONS: There was little difference in the occurrence of post-LP headache or any headache between procedures carried out using the 22-gauge or 25-gauge needles. Depending on the circumstances of the procedure and the experience of the operator, either gauge may be appropriate for an LP in a child.
Catherine Crock; Francesca Orsini; Katherine J Lee; Roderic J Phillips
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-11-14
Journal Detail:
Title:  Archives of disease in childhood     Volume:  -     ISSN:  1468-2044     ISO Abbreviation:  Arch. Dis. Child.     Publication Date:  2013 Nov 
Date Detail:
Created Date:  2013-11-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372434     Medline TA:  Arch Dis Child     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Royal Children's Hospital, , Melbourne, Australia.
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