Comparing Ultrasonography and Surface Landmark-Guided Lumbar Puncture in Patients with Obesity and Difficult Anatomy, a Randomized Controlled Trial

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Sanguanwit Pitsucha; Tansuwannarat Phantakan; Bua Ngam Chinnarat; Suttabuth Supakrid; Atiksawedparit Pongsakorn; Trakulsrichai Satariya

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Journal: Archives of Academic Emergency Medicine Year:621 | Volume: | Issue: Page(s): 0-0

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Title

Comparing Ultrasonography and Surface Landmark-Guided Lumbar Puncture in Patients with Obesity and Difficult Anatomy, a Randomized Controlled Trial

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Keywords

Spinal Puncture

Ultrasonography

Interventional

Obesity

Emergency Service

Hospital

Abstract

Introduction: Previous studies have shown higher lumbar puncture (LP) success rates when using ultrasound guidance. This study aimed to compare the first-attempt success rate of ultrasound-guided LP with blind technique of needle insertion using the palpable spinal surface landmark in patients with Obesity or a difficult anatomy. Methods: This prospective randomized controlled study was performed at the emergency department of Ramathibodi Hospital, an academic tertiary university Hospital, from August 2015 to July 2016. Results: 40 patients were enrolled (20 surface landmark-guided and 20 ultrasound-guided LPs). 52. 5% of the patients were male with the mean age of 60. 33 ±,4. 24 years. The first-attempt success rate in the ultrasound-guided LP group was significantly higher than the landmarkguided LP group (80% vs. 35%, respectively), with risk difference (RD) of 45. 00% (95% confidence interval (CI): 17. 72%, 72. 28%). This indicated absolute risk reduction and number needed to treat of 45. 00% and 2. 22, respectively. The median procedural duration required to achieve successful LP in the ultrasound-guided LP group was significantly shorter than the surface landmark-guided LP group (5 [IQR: 3–, 18]minutes vs. 13. 5 [IQR: 5-30] minutes, respectively). Traumatic puncture as a complication occurred less frequently in the ultrasound-guided LP group than the surface landmarkguided LP group with risk ratio (RR) = 0. 33 (95% CI: 0. 08, 1. 46) and RD =-20. 00% (95% CI:-44. 00%, 4. 00%). This indicated absolute risk reduction and number needed to harmof 20. 00% and 5. 00, respectively. However, the difference was not significant. Conclusion: Using ultrasound to help localize the insertion point before LP increased the first-attempt success rate and improved other LP outcomes in Thai patients with Obesity or a difficult anatomy. It also shortened the procedural duration and reduced the incidence of traumatic tap.

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APA: Copy

Sanguanwit, Pitsucha, Tansuwannarat, Phantakan, Bua Ngam, Chinnarat, Suttabuth, Supakrid, Atiksawedparit, Pongsakorn, & Trakulsrichai, Satariya. (2023). Comparing Ultrasonography and Surface Landmark-Guided Lumbar Puncture in Patients with Obesity and Difficult Anatomy, a Randomized Controlled Trial. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE (EMERGENCY), 11(1), 0-0. SID. https://sid.ir/paper/1116049/en

Vancouver: Copy

Sanguanwit Pitsucha, Tansuwannarat Phantakan, Bua Ngam Chinnarat, Suttabuth Supakrid, Atiksawedparit Pongsakorn, Trakulsrichai Satariya. Comparing Ultrasonography and Surface Landmark-Guided Lumbar Puncture in Patients with Obesity and Difficult Anatomy, a Randomized Controlled Trial. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE (EMERGENCY)[Internet]. 2023;11(1):0-0. Available from: https://sid.ir/paper/1116049/en

IEEE: Copy

Pitsucha Sanguanwit, Phantakan Tansuwannarat, Chinnarat Bua Ngam, Supakrid Suttabuth, Pongsakorn Atiksawedparit, and Satariya Trakulsrichai, “Comparing Ultrasonography and Surface Landmark-Guided Lumbar Puncture in Patients with Obesity and Difficult Anatomy, a Randomized Controlled Trial,” ARCHIVES OF ACADEMIC EMERGENCY MEDICINE (EMERGENCY), vol. 11, no. 1, pp. 0–0, 2023, [Online]. Available: https://sid.ir/paper/1116049/en

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