The Experts below are selected from a list of 36225 Experts worldwide ranked by ideXlab platform
Luis F. Ochoa - One of the best experts on this subject based on the ideXlab platform.
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Role of local anesthesia during Lumbar Puncture in neonates.
Pediatrics, 1993Co-Authors: J.m. Pinheiro, S Furdon, Luis F. OchoaAbstract:Local anesthesia decreases physiologic responses to pain in neonates but has not been used routinely during Lumbar Punctures in newborns, as it might obscure anatomical landmarks. However, local anesthesia may decrease newborns' struggling during Lumbar Puncture, thus facilitating the procedure and increasing its success rate. The success rate of Lumbar Punctures was compared in neonates allocated prospectively to 0.2 to 0.5 mL of 1% lidocaine anesthesia (n = 48) or a control group (n = 52). Newborns were held in a modified lateral recumbent position (neck not flexed) and their struggling response to the various steps in the Lumbar Puncture was scored by the holder. The newborns' struggling motion score increased in response to lidocaine injection, but response to the subsequent spinal needle insertion was significantly decreased. Despite this decreased motion, no differences were noted in the number of attempts per Lumbar Puncture (1.9 +/- 0.2 [SEM] in lidocaine and 2.1 +/- 0.2 in control groups), rate of Lumbar Puncture failure (15% in lidocaine and 19% in control groups), or the number of traumatic Lumbar Punctures (46% in both groups). The success rate of Lumbar Puncture was not dependent on level of training of physicians performing the procedure. No acute complications, cerebrospinal fluid contamination, or subsequent meningitis was noted in either group. It is concluded that local anesthesia with lidocaine decreases the degree of struggling but does not alter the success rate of Lumbar Puncture in neonates. The practice of withholding lidocaine anesthesia from neonates undergoing Lumbar Punctures cannot be justified by arguing that it makes the procedure more difficult to perform.
Martin B. Kleiman - One of the best experts on this subject based on the ideXlab platform.
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Incidence and Effect of Traumatic Lumbar Puncture in the Neonate
Developmental medicine and child neurology, 2008Co-Authors: Richard L. Schreiner, Martin B. KleimanAbstract:The incidence of non-traumatic, traumatic and unsuccessful Lumbar Punctures in 181 neonates was similar whether a needle with a stylet, a butterfly needle without stylet, or a standard veniPuncture needle without stylet was used. Comparison of 20 Lumbar Puncture pairs in 17 patients showed that traumatic Lumbar Puncture does not result in a cerebrospinal fluid pleocytosis between two and 13 days after initial traumatic Lumbar Puncture.
A Tuladhar - One of the best experts on this subject based on the ideXlab platform.
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Is Lumbar Puncture necessary for evaluation of early neonatal sepsis
Archives of disease in childhood, 2006Co-Authors: B Ray, J Mangalore, C Harikumar, A TuladharAbstract:A newborn baby born at 37 weeks is noted to be unwell at 18 h postnatally. The mother gives a history of prolonged rupture of membranes for 36 h. The baby is feeding poorly and is jittery, with a temperature of 38°C. A clinical diagnosis of early sepsis is made and Lumbar Puncture is suggested on the ward round as a part of sepsis evaluation. Several publications on the use of Lumbar Puncture in late-onset sepsis, including a recent review article by Malbon et al,1 suggest that Lumbar Puncture is an important method of investigation and should be considered in babies for >48 h old, with suspected sepsis. We wonder whether there is sufficient evidence to justify Lumbar Puncture in early sepsis. In a newborn (patient), is Lumbar Puncture (intervention) necessary to rule out meningitis in suspected sepsis (outcome) in the first few …
Jose A Perez - One of the best experts on this subject based on the ideXlab platform.
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subdural hematoma following Lumbar Puncture
JAMA Internal Medicine, 2002Co-Authors: Donald J Gaucher, Jose A PerezAbstract:A post-dural Puncture headache is a potential complication of a Lumbar Puncture. Physicians should be able to readily diagnose and treat this potential complication. Described here is a patient who developed an unresolving post-dural Puncture headache that then developed into a subdural hematoma. A subdural hematoma is a rare complication following Lumbar Punctures. Unresolving headaches following a Lumbar Puncture should prompt aggressive investigation.
J.m. Pinheiro - One of the best experts on this subject based on the ideXlab platform.
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Role of local anesthesia during Lumbar Puncture in neonates.
Pediatrics, 1993Co-Authors: J.m. Pinheiro, S Furdon, Luis F. OchoaAbstract:Local anesthesia decreases physiologic responses to pain in neonates but has not been used routinely during Lumbar Punctures in newborns, as it might obscure anatomical landmarks. However, local anesthesia may decrease newborns' struggling during Lumbar Puncture, thus facilitating the procedure and increasing its success rate. The success rate of Lumbar Punctures was compared in neonates allocated prospectively to 0.2 to 0.5 mL of 1% lidocaine anesthesia (n = 48) or a control group (n = 52). Newborns were held in a modified lateral recumbent position (neck not flexed) and their struggling response to the various steps in the Lumbar Puncture was scored by the holder. The newborns' struggling motion score increased in response to lidocaine injection, but response to the subsequent spinal needle insertion was significantly decreased. Despite this decreased motion, no differences were noted in the number of attempts per Lumbar Puncture (1.9 +/- 0.2 [SEM] in lidocaine and 2.1 +/- 0.2 in control groups), rate of Lumbar Puncture failure (15% in lidocaine and 19% in control groups), or the number of traumatic Lumbar Punctures (46% in both groups). The success rate of Lumbar Puncture was not dependent on level of training of physicians performing the procedure. No acute complications, cerebrospinal fluid contamination, or subsequent meningitis was noted in either group. It is concluded that local anesthesia with lidocaine decreases the degree of struggling but does not alter the success rate of Lumbar Puncture in neonates. The practice of withholding lidocaine anesthesia from neonates undergoing Lumbar Punctures cannot be justified by arguing that it makes the procedure more difficult to perform.
