lumbar puncture definition ,indications, needle size, patient position ,article,complications

2. DEFINITION
•Puncture of the subarachnoid space in the
lumbar region of the spinal cord to withdraw
cerebrospinal fluid or inject drugs.

4. PURPOSES
• collect a sample of cerebrospinal fluid
• measure the pressure of fluid in the spinal canal
• inject drugs
• To detect
• bacterial, fungal and viral infections, including meningitis,
encephalitis and syphilis
• bleeding around the brain (subarachnoid hemorrhage)
• cancers involving the brain and spinal cord
• inflammatory conditions of the nervous system, including
Guillain-Barre syndrome and multiple sclerosis.

8. INDICATIONS
• Diagnosis of diseases with altered CSF composition
• Intrathecal administration of pharmaceuticals
• CSF pressure measurement

9. NEEDLE TYPES

10. NEEDLE FOR LP

12. GAUGE (mm) COLOR CODE
16G (1.6 mm) White
18G (1.2 mm) Pink
19G (1.1 mm) Cream
20G (0.9 mm) Yellow
21G (0.8mm) Deep green
22G (0.7 mm) Black
24G (0.6 mm) Deep blue
25G (0.5 mm) Orange
26G (0.45mm) Brown
27G (0.4mm)
SPINAL NEEDLE SIZES

13. Parameter Normal value
Total volume 150 ml
CSF pressure 6- 14 mmof HG
Specific gravity 1.006 – 1.008
Glucose 40 – 70 mg/dl
Proteins 20 – 40 mg/dl
Lactate 1 – 2mmol/L
Red blood cells None
White blood cells 0 – 5 cells/ microliter

14. ARTICLES
• STERILE DRESSING
• STERILE GLOVES
• STERILE DRAPE
• ANTISEPTIC SOLUTION WITH SKIN
SWABS
• LIDOCAINE 1% WITHOUT
EPINEPHRINE
• SYRINGE, 3 ML
• NEEDLES, 20 AND 25 GAUGE
• SPINAL NEEDLES, 20 AND 22 GAUGE
• THREE-WAY STOPCOCK
• MANOMETER
• FOUR PLASTIC TEST TUBES,

15. COMPLICATIONS
• Post–spinal puncture headache
Headache is the most common
complication of lumbar puncture,
observed in 20-70% of patients. It
usually begins 24-48 hours after the
procedure and is more common in
young adults.

16. 2) BLOODY TAP

17. 3) DRY TAP

18. 4)INFECTION
•Cellulitis, skin abscesses, epidural
abscesses, spinal abscesses, and discitis
can result from a contaminated spinal
needle

19. 5)HEMORRHAGE

20. DYSESTHESIA
IRRITATION OF NERVES OR NERVE
ROOTS BY THE SPINAL NEEDLE CAN
CAUSE DIFFERENT LOWER-EXTREMITY
DYSESTHESIAS.

21. 6) POST–DURAL PUNCTURE CEREBRAL
HERNIATION
• withdrawal of fluid when initial pressures are abnormal
could result in spinal cord compression or cerebral
herniation