Rates of Epidural Blood Patch following Lumbar Puncture Comparing Atraumatic versus Bevel-Tip Needles Stratified for Body Mass Index.
| Autor: | Philip JT; From the AdventHealth Medical Group Radiology at Central Florida (J.T.P., M.A.F., R.D.B., S.C.D.), Orlando, Florida Justin.philip.md@adventhealth.com., Flores MA; From the AdventHealth Medical Group Radiology at Central Florida (J.T.P., M.A.F., R.D.B., S.C.D.), Orlando, Florida., Beegle RD; From the AdventHealth Medical Group Radiology at Central Florida (J.T.P., M.A.F., R.D.B., S.C.D.), Orlando, Florida., Dodson SC; From the AdventHealth Medical Group Radiology at Central Florida (J.T.P., M.A.F., R.D.B., S.C.D.), Orlando, Florida., Messina SA; Department of Neuroradiology (S.A.M.), Mayo Clinic Rochester, Rochester, Minnesota., Murray JV; Department of Neuroradiology (J.V.M.), Mayo Clinic, Jacksonville, Florida. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | AJNR. American journal of neuroradiology [AJNR Am J Neuroradiol] 2022 Feb; Vol. 43 (2), pp. 315-318. Date of Electronic Publication: 2022 Jan 13. |
| DOI: | 10.3174/ajnr.A7397 |
| Abstrakt: | Background and Purpose: Postdural puncture headache, a known complication of lumbar puncture, typically resolves with conservative management. Symptoms persist in a minority of patients, necessitating an epidural blood patch. One method of decreasing rates of postdural puncture headache is using atraumatic, pencil-point needles rather than bevel-tip needles. To the best of our knowledge, this is the first study comparing epidural blood patch rates between pencil- and bevel-tip needles with a subgroup analysis based on body mass index. Materials and Methods: This single-institution retrospective study identified 4435 patients with a recorded body mass index who underwent a lumbar puncture with a 22-ga pencil-tip Whitacre needle, a 20-ga bevel-tip Quincke needle, or a 22-ga Quincke needle. The groups were stratified by body mass index. We compared epidural blood patch rates between 22-ga pencil-tip Whitacre needles versus 22-ga Quincke needles and 22-ga Quincke needles versus 20-ga bevel-tip Quincke needles using the Fischer exact test and χ 2 test. Results: Postdural puncture headache necessitating an epidural blood patch was statistically more likely using a 22-ga Quincke needle in all patients ( P < .001) and overweight ( P = .03) and obese ( P < .001) populations compared with using a 22-ga pencil-tip Whitacre needle. In the normal body mass index population, there was no statistically significant difference in epidural blood patch rates when using a 22-ga pencil-tip Whitacre needle compared with a 22-ga Quincke needle ( P = .12). There was no significant difference in epidural blood patch rates when comparing a 22-ga Quincke needle versus a 20-ga bevel-tip Quincke needle in healthy ( P = .70), overweight ( P = .69), or obese populations ( P = .44). Conclusions: Using a 22-ga pencil-tip Whitacre needle resulted in lower epidural blood patch rates compared with a 22-ga Quincke needle in all patients. Subgroup analysis demonstrated a statistically significant difference in epidural blood patch rates in overweight and obese populations, but not in patients with a normal body mass index. (© 2022 by American Journal of Neuroradiology.) |
| Databáze: | MEDLINE |
| Externí odkaz: |
|