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01-07-2020 | Headache | Original Communication

A protocol to reduce self-reported pain scores and adverse events following lumbar punctures in older adults

Authors: Chloe K. Nobuhara, W. Michael Bullock, Thomas Bunning, Brian Colin, Mary Cooter, Michael J. Devinney, Michael N. Ferrandino, Jeffrey Gadsden, Grant Garrigues, Ashraf S. Habib, Eugene Moretti, Judd Moul, Brian Ohlendorf, Aaron Sandler, Randall Scheri, Bharat Sharma, Jake P. Thomas, Christopher Young, Joseph P. Mathew, Miles Berger, For the MADCO-PC and INTUIT Investigators Teams

Published in: Journal of Neurology | Issue 7/2020

Abstract

Objective

Lumbar punctures (LPs) are important for obtaining CSF in neurology studies but are associated with adverse events and feared by many patients. We determined adverse event rates and pain scores in patients prospectively enrolled in two cohort studies who underwent LPs using a standardized protocol and 25 g needle.

Methods

Eight hundred and nine LPs performed in 262 patients age ≥ 60 years in the MADCO-PC and INTUIT studies were analyzed. Medical records were monitored for LP-related adverse events, and patients were queried about subjective complaints. We analyzed adverse event rates, including headaches and pain scores.

Results

There were 22 adverse events among 809 LPs performed, a rate of 2.72% (95% CI 1.71–4.09%). Patient hospital stay did not increase due to adverse events. Four patients (0.49%) developed a post-lumbar puncture headache (PLPH). Twelve patients (1.48%) developed nausea, vasovagal responses, or headaches that did not meet PLPH criteria. Six patients (0.74%) reported lower back pain at the LP site not associated with muscular weakness or paresthesia. The median pain score was 1 [0, 3]; the mode was 0 out of 10.

Conclusions

The LP protocol described herein may reduce adverse event rates and improve patient comfort in future studies.

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Title: A protocol to reduce self-reported pain scores and adverse events following lumbar punctures in older adults
Authors: Chloe K. Nobuhara
W. Michael Bullock
Thomas Bunning
Brian Colin
Mary Cooter
Michael J. Devinney
Michael N. Ferrandino
Jeffrey Gadsden
Grant Garrigues
Ashraf S. Habib
Eugene Moretti
Judd Moul
Brian Ohlendorf
Aaron Sandler
Randall Scheri
Bharat Sharma
Jake P. Thomas
Christopher Young
Joseph P. Mathew
Miles Berger
For the MADCO-PC and INTUIT Investigators Teams
Publication date: 01-07-2020
Publisher: Springer Berlin Heidelberg
Keywords: Headache
Back Pain
Back Pain
Back Pain
Published in: Journal of Neurology / Issue 7/2020
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-020-09797-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A protocol to reduce self-reported pain scores and adverse events following lumbar punctures in older adults

Abstract

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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