Comparison of Ultrasound-assisted Lumbar Puncture with Lumbar Puncture using Palpation of Landmarks in Aged Patients in an Emergency Center

ABSTRACT

PURPOSE: We evaluated the utility of ultrasound-assisted lumbar puncture (UALP) in aged patients who visited our emergency center. METHODS:This was a prospective, randomized, controlled study. From July to December 2007 we enrolled patients who were at least 60 years of age . Patients were divided into a group that had lumbar puncture (LP) using landmark palpation (group A) and a UALP group (group B). We did between-group comparisons for the number of attempts, procedure time, the number of LP failures, and whether traumatic LP was done. For all hypotheses, a significance level of 0.05 was used. Variables are reported as percentages and mean +/-standard deviation. RESULTS: We enrolled sixty aged patients 30 in group A and 30 in group B. There were 5 cases of LP failure in group A and none in group B (p<0.05). There were 6 cases of traumatic lumbar puncture in group A, and one case in group B (p=0.05). The number of attempts was 3.3+/-2.4 in group A and 1.5+/-0.8 in group B (p<0.05). It took 10.6+/-7.7 minutes to finish each LP in group A compared to 5.3+/-4.2 minutes in group B (p<0.05). CONCLUSION: The use of ultrasound-assisted lumbar puncture significantly reduces the number of failures, the number of attempts, and the procedure time in aged patients.