Low Incidence of Postdural Puncture Headache Further Reduced With Atraumatic Spinal Needle: A Retrospective Cohort Study.

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Tytuł:: Low Incidence of Postdural Puncture Headache Further Reduced With Atraumatic Spinal Needle: A Retrospective Cohort Study.
Autorzy:: Farhat NY; Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland. Electronic address: .
Farmer C; Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, NIH, DHHS, Bethesda, Maryland.
Do AD; Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
Bianconi S; Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
Porter FD; Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
Źródło:: Pediatric neurology [Pediatr Neurol] 2021 Jan; Vol. 114, pp. 35-39. Date of Electronic Publication: 2020 Oct 09.
Typ publikacji:: Journal Article; Observational Study; Research Support, N.I.H., Intramural
Język:: English
Imprint Name(s):: Publication: New York Ny : Elsevier Science Publishing
Original Publication: Chippewa Falls, Wis. : Professional Publications, [c1985-
MeSH Terms:: Needles*
Post-Dural Puncture Headache/*epidemiology
Spinal Puncture/*instrumentation
Spinal Puncture/*statistics & numerical data
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Incidence ; Infant ; Male ; Middle Aged ; Post-Dural Puncture Headache/etiology ; Quality Improvement ; Retrospective Studies ; Risk Assessment ; Spinal Puncture/adverse effects ; Young Adult
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Grant Information:: ZIA HD008824 United States ImNIH Intramural NIH HHS
Contributed Indexing:: Keywords: Cerebrospinal fluid; Lumbar puncture; Pediatric risk assessment; Quality improvement
Entry Date(s):: Date Created: 20201115 Date Completed: 20211116 Latest Revision: 20220102
Update Code:: 20240105
PubMed Central ID:: PMC7770053
DOI:: 10.1016/j.pediatrneurol.2020.10.001
PMID:: 33190071
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Background: The purpose of the study was to evaluate the incidence of postdural puncture headache in a predominantly pediatric sample before and after a transition from conventional to atraumatic spinal needles.
Methods: In this retrospective cohort study, we analyzed data from 1059 lumbar puncture procedures in 181 individuals enrolled in NIH Clinical Center research protocols. Multivariate logistic regression was used to evaluate the association between postdural puncture headache and spinal needle type after adjusting for patient age, sex, and body mass index. A random effect of participant was used to accommodate repeated observations.
Results: The median age at time of procedure was 15.3 years. The overall rate of postdural puncture headache was 5.1% (54 of 1059). With conventional needles and atraumatic needles, respectively, the rate of postdural puncture headache was 7.7% (43 of 588) and 2.3% (11 of 471); (odds ratio 0.32, 95% confidence interval 0.15 to 0.68).
Conclusions: Lumbar puncture for cerebrospinal fluid collection is an essential and common procedure in pediatric clinical care and research. Postdural puncture headache is the most common adverse event of the lumbar puncture procedure. Our data indicate that lumbar puncture is safe in pediatrics and that use of an atraumatic spinal needle further reduces the risk of postdural puncture headache.
(Copyright © 2020 Elsevier Inc. All rights reserved.)

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