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Lumbar Puncture

WHAT YOU NEED TO KNOW:

Lumbar puncture (LP) is a procedure in which a needle is inserted in your back and into your spinal canal. This is usually done to collect cerebrospinal fluid (CSF) to check for an infection, inflammation, bleeding, or other conditions that affect the brain. CSF is a clear, protective fluid that flows around the brain and inside the spinal canal. LP may also be done to remove CSF to reduce pressure in the brain.

WHILE YOU ARE HERE:

Before your procedure:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

During your procedure:

  • You will be asked to lie on your side or to sit up. If you are on your side, your knees will be bent and drawn up toward your chest. Your neck will be tucked toward your chest and you may be given a pillow. If you are sitting, you will need to bend forward with your neck tucked toward your chest. You may be given medicine to help you relax or make you drowsy.
  • Your healthcare provider will feel your lower spine to look for the best place to do the LP. He will mark this position using a marker. Your lower back is cleaned. You may be given one or more shots of numbing medicine under the skin. A needle is inserted between the vertebrae (spine) in your lower back. You may feel some pushing or discomfort as the needle enters your back. Tell your healthcare provider if you have pain that does not stop within a few seconds. Your healthcare provider may need to pull out, reinsert, or change the position of the needle.
  • Your healthcare provider may take readings of your CSF pressure. This is done by connecting a measuring device to the needle. After the pressure is measured, the device is removed and CSF is allowed to flow out of the needle. Samples of your CSF may be taken and placed in sterile bottles. The needle is then taken out and the area will be covered with a bandage.

After your procedure:

You should lie flat in bed until your healthcare provider says it is okay to get up. When healthcare providers see that you are okay, you may be allowed to go home. If healthcare providers want you to stay in the hospital, you will be taken back to your hospital room. Tell a healthcare provider if you have a headache, back pain, or tingling, numbness, or weakness below your waist.

  • Medicines:
    • Acetaminophen: This medicine decreases pain and lowers a fever. Acetaminophen can cause liver damage.
    • NSAIDs: These medicines decrease swelling, pain, and fever. NSAIDs can cause stomach bleeding or kidney problems if not taken correctly.
    • Pain medicine: You may be given a prescription medicine to decrease severe pain. Do not wait until the pain is severe before you ask for more pain medicine.
  • Post-lumbar puncture headache: You may develop a headache during the first few hours after your LP that may last for several days. The headache may be mild to severe and may get worse when you sit or stand. The following may be used to treat a post-lumbar puncture headache:
    • Liquids: You may be asked to drink more liquid than usual after your LP. Ask your healthcare provider how much liquid is right for you.
    • Caffeine: Caffeine may be used to treat a LP headache. Caffeine may be given in drinks, such as coffee or soda, every 4 to 6 hours. You may also be given caffeine through an IV.
  • Monitoring:
    • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
    • Neurologic exam: This is also called neuro signs, neuro checks, or neuro status. A neurologic exam can show caregivers how well your brain works after an injury or illness. Caregivers will check how your pupils (black dots in the center of each eye) react to light. They may check your memory and how easily you wake up. Your hand grasp and balance may also be tested.

RISKS:

You may have a headache that gets worse when you sit or stand. You may also have neck or back pain. There may be bleeding, infection, or injury to a disk in your spine. Spinal fluid may leak from the puncture site. Your nerves or spinal cord may be damaged. Patients who have blood disorders or who are taking certain medicines are at a higher risk for problems.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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