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J Korean Soc Emerg Med > Volume 25(2); 2014 > Article
Journal of The Korean Society of Emergency Medicine 2014;25(2): 189-194.
Comparison between Classical Lumbar Puncture and Ultrasonography-Assisted Lumbar Puncture in the Pediatric Patients
Chang Yob Kim, Won Joon Jeong, Won Suk Lee
1Department of Emergency, Eulji University Hospital, Daejeon, Korea. medulla@hanmail.net
2Department of Emergency, Dong-A University Medical Center, Busan, Korea.
3Department of Emergency, Chungnam National University Hospital, Daejeon, Korea.
We would like to study the effectiveness and safety during lumbar puncture by classic lumbar puncture and ultrasonography-assisted lumbar puncture in pediatric patients.
This was a prospective randomized controlled trial. We included under 14-year-old pediatric patients who needed to undergo lumbar puncture from May 2010 to August 2011. Patients were divided according to classic lumbar puncture (group A) and ultrasonography-assisted lumbar puncture (group B). Data were collected, including the patient's age, sex, height, underlying disease of vertebrate, weight, frequency of attempting procedure, procedure time, and failure of lumbar puncture.
Group A and group B included 31 patients and 33 patients each, with average ages of 9.65+/-8.53 and 7.38+/-4.45(p=0.19), average heights of 126.65+/-29.81 cm and 122.39+/-30.01 cm (p=0.57), and average weights of 32.84 +/-20.68 kg and 29.17+/-16.96 kg (p=0.44), without statistically significant differences. Of the distribution of residencies who underwent lumbar puncture between the two groups, no statistically significant differences were observed (p=0.30). Lumbar puncture time in group A was 6.72+/-9.16 minutes and 3.88+/-1.51 minutes in group B, but without significant differences (p=0.098). The number of lumbar puncture attempts was 1.68+/-0.95 in group A and 1.45+/-0.56 in group B, without significant statistical difference (p=0.253). The number of patients who failed lumbar puncture was 11 in group A and 3 in group B, showing a statistically significant difference (p=0.015).
Compared to the classic lumbar puncture, lumbar puncture using ultrasonography in pediatric patients did not reduce the number of proceduresand the time for the procedure, but reduced the failure rate. Therefore, we recommend the methods of lumbar puncture assisted by ultrasonography in pediatric patients as an effective method for use in the emergency department.
Key words: Ultrasonography, Spinal puncture, Pediatrics
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