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Under Utilization of local anesthetics in infant lumbar punctures

Julie Gorchynski1, Worth Everett, Linda Prebil

  • 1Texas A&M, Corpus Christi.

The Western Journal of Emergency Medicine
|June 30, 2009
PubMed

Insights

Local analgesia is underused in infants and neonates undergoing lumbar puncture (LP). Routine use of local anesthetics like lidocaine or EMLA for pediatric LP is recommended to improve pain management.

Area of Science:

  • Pediatric Medicine
  • Pain Management
  • Medical Procedures

Background:

  • Lumbar puncture (LP) is a common diagnostic procedure for meningitis in infants.
  • Local anesthesia is not routinely administered to neonates and infants prior to LP.

Purpose of the Study:

  • To assess the utilization of local analgesics by physicians for infants undergoing LP.
  • To identify specific local anesthetics used in pediatric patients.

Main Methods:

  • Prospective cohort study involving infants aged six months or younger.
  • Data collected from a university tertiary care hospital over one year.
  • Comparison group of 42 adults undergoing LP.

Main Results:

  • Only 40.4% of infants received local analgesia (lidocaine, EMLA, or combination) before LP.
  • Infants were significantly less likely than adults to receive local anesthesia (OR=0.27).
  • No neonates under one month received analgesia; use increased with infant age.

Conclusions:

  • Findings confirm the underutilization of analgesia for pediatric lumbar punctures.
  • Recommends routine administration of local anesthetics for all pediatric LPs without exception.
Abstract

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