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CSF pressure measurement during anesthesia: an unreliable technique
Tal Eidlitz-Markus1, Hadas Stiebel-Kalish, Yehoshua Rubin
1Department of Pediatrics E-Ambulatory Day Care Center, Schneider Children's Medical Center of Israel, Petah Tiqva, Israel. eidlitz@post.tau.ac.il
Paediatric Anaesthesia
|December 6, 2005
Summary
General anesthesia during lumbar puncture may affect cerebrospinal fluid (CSF) pressure measurements. Opening and end-measurement pressures often differ significantly, potentially making CSF pressure readings unreliable under anesthesia.
Area of Science:
- Neurology
- Anesthesiology
- Pediatrics
Background:
- Cerebrospinal fluid (CSF) pressure measurement is clinically essential.
- Accurate CSF pressure readings can be challenging in uncooperative pediatric patients.
- General anesthesia's impact on CSF pressure requires evaluation.
Purpose of the Study:
- To assess the influence of general anesthesia on cerebrospinal fluid pressure measurements.
- To compare CSF pressure readings obtained under general anesthesia.
Main Methods:
- Lumbar puncture performed under general anesthesia in 15 pediatric patients (aged 4.5-20 years).
- Cerebrospinal fluid pressure measured using a manometer (opening pressure) and continuously recorded until consciousness.
- Comparison of opening pressure with end-measurement pressure.
Main Results:
- Significant differences observed between opening and end-measurement CSF pressures in most patients (5-13 cmH2O).
- Abnormally high opening pressure noted in 16 measurements; high end pressure in seven.
- The difference between opening and end pressures was statistically significant (P < 0.001).
Conclusions:
- Lumbar puncture under general anesthesia can produce variable CSF pressure measurements.
- Factors like hypercarbia and anesthetic agents may influence CSF pressure readings.
- Dynamic changes under anesthesia may render CSF pressure measurements unreliable.
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