BACKGROUND CONTEXT: The most common adverse event after a lumbar puncture (LP) is a headache: In anaesthesiology, well studied is the protective effect of atraumatic spinal needles, and they are routinely used. However, this is less well known in diagnostic LP, and neurologists use atraumatic needles in less than 2% of times. PURPOSE: The purpose of this study was to define the impact of needle type, atraumatic (Sprotte [S]) versus traumatic (Quincke [Q]) on postdural puncture headache (PDPH) incidence. STUDY DESIGN: The study is based on a prospective, randomized, and simple-blinded clinical trial. PATIENT SAMPLE: Patients older than 14 years were scheduled for a diagnostic or therapeutic LP. OUTCOME MEASURES: The outcome measure included the development of PDPH according to the International Headache Association criteria. METHODS:Patients fulfilling eligibility criteria were randomly allocated to one of two kinds of spinal needle: atraumatic or S-type or traumatic or Q-type. They were interviewed on days 2 and 7 about the development of PDPH. RESULTS: The incidence of PDPH was 22.43% with Q-type needle and 8.51% with S-type needle, p=.04. The duration of PDPH in patients in the S-type was 1 day or less, compared with a median of 4.14 days in the Q-type (p=.00). In the logistic regression model, the S-type needle together with the age of the patient were the only two statistically significant factors in the development of postlumbar puncture headache (PLPH), both of them being protective. CONCLUSIONS: We found a lower incidence of PDPH with atraumatic needles, and it was statistically significant compared with the traumatic needles. Our study confirms the effectiveness of the atraumatic needles to prevent PDPH.
RCT Entities:
BACKGROUND CONTEXT: The most common adverse event after a lumbar puncture (LP) is a headache: In anaesthesiology, well studied is the protective effect of atraumatic spinal needles, and they are routinely used. However, this is less well known in diagnostic LP, and neurologists use atraumatic needles in less than 2% of times. PURPOSE: The purpose of this study was to define the impact of needle type, atraumatic (Sprotte [S]) versus traumatic (Quincke [Q]) on postdural puncture headache (PDPH) incidence. STUDY DESIGN: The study is based on a prospective, randomized, and simple-blinded clinical trial. PATIENT SAMPLE: Patients older than 14 years were scheduled for a diagnostic or therapeutic LP. OUTCOME MEASURES: The outcome measure included the development of PDPH according to the International Headache Association criteria. METHODS:Patients fulfilling eligibility criteria were randomly allocated to one of two kinds of spinal needle: atraumatic or S-type or traumatic or Q-type. They were interviewed on days 2 and 7 about the development of PDPH. RESULTS: The incidence of PDPH was 22.43% with Q-type needle and 8.51% with S-type needle, p=.04. The duration of PDPH in patients in the S-type was 1 day or less, compared with a median of 4.14 days in the Q-type (p=.00). In the logistic regression model, the S-type needle together with the age of the patient were the only two statistically significant factors in the development of postlumbar puncture headache (PLPH), both of them being protective. CONCLUSIONS: We found a lower incidence of PDPH with atraumatic needles, and it was statistically significant compared with the traumatic needles. Our study confirms the effectiveness of the atraumatic needles to prevent PDPH.
Authors: Ingrid Arevalo-Rodriguez; Luis Muñoz; Natalia Godoy-Casasbuenas; Agustín Ciapponi; Jimmy J Arevalo; Sabine Boogaard; Marta Roqué I Figuls Journal: Cochrane Database Syst Rev Date: 2017-04-07
Authors: Hong Xu; Yang Liu; WenYe Song; ShunLi Kan; FeiFei Liu; Di Zhang; GuangZhi Ning; ShiQing Feng Journal: Medicine (Baltimore) Date: 2017-04 Impact factor: 1.889
Authors: Sebastiaan Engelborghs; Ellis Niemantsverdriet; Hanne Struyfs; Kaj Blennow; Raf Brouns; Manuel Comabella; Irena Dujmovic; Wiesje van der Flier; Lutz Frölich; Daniela Galimberti; Sharmilee Gnanapavan; Bernhard Hemmer; Erik Hoff; Jakub Hort; Ellen Iacobaeus; Martin Ingelsson; Frank Jan de Jong; Michael Jonsson; Michael Khalil; Jens Kuhle; Alberto Lleó; Alexandre de Mendonça; José Luis Molinuevo; Guy Nagels; Claire Paquet; Lucilla Parnetti; Gerwin Roks; Pedro Rosa-Neto; Philip Scheltens; Constance Skårsgard; Erik Stomrud; Hayrettin Tumani; Pieter Jelle Visser; Anders Wallin; Bengt Winblad; Henrik Zetterberg; Flora Duits; Charlotte E Teunissen Journal: Alzheimers Dement (Amst) Date: 2017-05-18