Acil servise başvuran yetişkin hastalarda lomber ponksiyon yerinin yatak başı ultrasonografi ve palpasyon ile karşılaştırılması

Abstract

Purpose: Lumbar puncture (LP) is a medical procedure in which a cerebrospinal fluid sample is taken for biochemical, microbiological and cytological examination. The aim of our study was to compare the ultrasonography (USG) method to the palpation method in determining the location of LP. Methods: 203 patients were included in the study. In the study, specifying location manually or with USG was performed by the same emergency medicine resident with USG certificate who completed his 4 th year. LP points were determined and marked firstly by ultrasound and then the manual method while the patients were in the left and right lateral decubitus and sitting positions. Results: The USG method was found to be significantly more successful than the manual method in determining the LP location (p=0.012). The USG method was found to be significantly more successful in determining the LP site than the manual method, especially when the LP site was identified in the sitting position (p=0.031). In other positions, no difference was observed between the two groups (Right p=1, Left p=0.500). Body Mass Index (BMI) affects success during site location with USG (p=0.0001). Likewise, BMI affected the success in identifying the LP site by the manual method (p=0.0001). The USG method was found to be significantly more successful than the manual method in determining the LP site in patients with BMI>25 (p=0.012). Conclusion: During the detection of LP location by palpation or USG, as the BMI increased, the duration of the determination of location increased significantly, too. LP site can be identified by the USG in patients whose LP site cannot be specified by palpation. In addition, the USG is more successful in obese individuals in terms of locating the LP site.