ULTRASOUND GUIDED LUMBAR PUNCTURE IN CHILDREN – A RANDOMIZED CONTROLLED STUDY
Aim: Lumbar puncture (LP) is one of the most common procedures performed in Pediatric department. First-attempt success rates remain low with frequent traumatic LP. The objective of the study was to evaluate whether the use of ultrasound imaging improves the effectiveness of lumbar puncture (LP) procedures in Pediatric medicine and to examine any potential complications compared to the traditional palpation method. Material & Methods: A Randomized controlled study was conducted in a tertiary care center. Eligible participants were children younger than 14 years of age, requiring LP as a part of the clinical workup and were randomized to either the standard landmark-based LP (SLP) or ultrasound-assisted LP (UALP) groups. The primary outcome was the first-attempt LP success rate. Results: 66 children were enrolled, with 34 in the UALP and 32 in the SLP group. Our primary outcome, the proportion of successful first-attempt LP success was higher in the ultrasound group (64.7%) than for the standard procedure (56.2%). However, this failed to reach statistical significance (p=0.97). The Total Time for Lumbar puncture was 6.38±1.93 min in control group and 3.59±1.04 min in experimental group. The difference was found statistically significant (p value <0.001) as was change of provider in UALP (p value 0.02) Conclusion: The study found no statistically significant difference in carrying out successful LP in first attempt. However, Ultrasound-assisted LP reduced traumatic taps and the number of puncture attempts in the pediatric age group but it was also statistically not significant in our study. Time for LP as well as change of provider was significantly less in experimental group. Studies with larger populations and different methodologies like real time ultrasound while doing Lumbar puncture are required on this subject.
Ultrasonography, Pediatric, Lumbar puncture, Meningitis.