Lumbar Puncture Procedure

Lumbar Puncture Procedure

Indication

Diagnostic

  1. Meningitis

Therapeutic

  1. Administration of drugs
  2. Decrease intracranial pressure
  3. Guillain–Barré syndrome

Contraindication

  1. Increased ICP
  2. Patients under anticoagulant therapy

Procedure

If patient is under anticoagulant therapy

  • Heparin
    • Stop the drug 4 days prior to the procedure
  • Aspirin
    • Stop the drug 7 days prior to the procedure

Instruments

  • Lumbar puncture needle 22 Gauge

Anaesthesia

  • Injection Lignocaine

Sample collection

  • 3 samples
  • 10ml each sample
    • Microbiology
    • Histopathology

If repeated procedure indicated

  • After 5 days of the previous procedure

Complication

  • Brain stem herniation
  • Post dural headache
    • Due to decreased ICP
    • Prevented by 1 hour lying down before getting up
    • Prevented by administration of paracetamol, caffeine, blood (epidural patch)
  • Bowel & bladder incontinence
    • Nerve damage due to negative pressure
  • Infection

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