• Sujay Halkur Shankar, Sagnik Biswas, Arvind Kumar, Akshita Gupta, Aastha Goel, Maroof Ahmad Khan, Rajesh Kumar Singh, Piyush Ranjan, Manish Soneja, and Naveet Wig.
• Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
• Postgrad Med J. 2021 Jan 1; 97 (1143): 23-28.

Purpose Of StudyUltrasound (US) for lumbar puncture has seen the most success in obese patients and in patients with difficult to palpate landmarks. We aimed to elucidate the advantage of the use of routine US for performing lumbar punctures over the traditional landmark method.Study DesignThis was a prospective study with consecutive sampling with a sample size of convenience. Three residents were chosen to perform the lumbar punctures after a training session. Patients were assigned to either the US group or the landmark group. The outcomes studied were number of attempts at needle insertion, patient and physician anxiety, pain experienced, time to procedure, number of traumatic attempts and the difficulties faced during the procedure.ResultsA total of 77 patients were included in this study, of which 36 patients (46.8%) underwent landmark-based lumbar puncture and 41 (53.2%) underwent US-guided lumbar puncture. There was no statistically significant difference between the two groups among the following characteristics: number of attempts to a successful procedure, number of traumatic punctures, procedure time, preprocedure anxiety of the participants and physicians and pain score rating of the procedure.ConclusionThere was no significant difference between the landmark method and US-guided method for performing lumbar puncture in the number of successful attempts, number of traumatic punctures, procedure time and pain during the procedure. Further studies are required to elucidate the advantage of the use of ultrasonography in subsets of the population such as the low body mass index population.© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.

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