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Objective and subjective side effects of research lumbar punctures in children and adolescents
M J Kruesi1, S E Swedo, M L Coffey
1Child Psychiatry Branch, National Institute of Mental Health, Bethesda, MD 20892.
Insights
Pediatric lumbar puncture (LP) is common, but children
Area of Science:
- Pediatric Medicine
- Clinical Procedures
- Child Psychology
Background:
- Lumbar punctures (LPs) are frequent in children, yet data on pediatric patient experiences and side effects are limited.
- Understanding the child's perspective is crucial for improving healthcare delivery and patient comfort during medical procedures.
Purpose of the Study:
- To systematically evaluate pediatric patients' perspectives on lumbar puncture (LP).
- To compare children's ratings of LP to other common hospital experiences.
- To assess the incidence of post-lumbar puncture headache in a pediatric cohort.
Main Methods:
- A subset of 20 children and adolescents with disruptive behavior disorders rated research lumbar punctures.
- Patient ratings were compared to experiences of blood sampling, electroencephalography (EEG), and school attendance.
- Incidence of post-lumbar puncture headache was recorded in 60 patients aged 6.5-19.8 years.
Main Results:
- Lumbar puncture (LP) was not rated significantly differently from other procedures in terms of patient preference.
- School attendance was the least preferred option for 50% of the patients.
- Post-lumbar puncture headache occurred in 22% (13 of 60) of pediatric patients.
Conclusions:
- Children's perspectives on lumbar puncture (LP) may not align with adult perceptions of its unpleasantness.
- The incidence of post-lumbar puncture headache is a notable side effect in pediatric populations.
- Further research should explore patient-reported outcomes to inform clinical practice regarding pediatric procedures.
Abstract:
Lumbar punctures are a common clinical procedure in pediatric populations, yet little systematic information about side effects or the child's perspective of the procedure is available. In a subset (n = 20) of a sample of children and adolescents with disruptive behavior disorders, we recorded children's ratings of research lumbar puncture in comparison to other hospital experiences of blood sampling, electroencephalography, and going to school. Lumbar puncture did not differ from the other procedures in terms of preference. (School attendance was the last choice of 50% of our patients.) Postlumbar puncture headache occurred in 13 of 60 (22%) patients (age 6.5-19.8 years). Adults may overestimate the relative noxiousness of lumbar punctures in children.