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- Title
Efficacy of ultrasound guidance for lumbar punctures: a systematic review and meta-analysis of randomised controlled trials.
- Authors
LiPei Shu; Jiao Huang; Jing Chen Liu; Shu, LiPei; Huang, Jiao; Liu, Jing Chen
- Abstract
Ultrasound guidance has been reported to facilitate the performance of lumbar punctures (LPs). However, the use of ultrasound guidance has not yet received consistent conclusions. We performed a systematic review and meta-analysis to determine the efficacy of ultrasound-guided LPs. PubMed, Embase and the Cochrane Library were searched for randomised controlled trials comparing ultrasound guidance with traditional palpation for LPs in adults. The primary outcome was risk of failed procedures. A random-effects Mantel-Haenzsel model or random-effects inverse variance model was used to calculate relative risks (RRs) or standardised mean differences (SMDs) with 95% CIs. Twenty-eight trials (N=2813) met the inclusion criteria. Ultrasound-guided LPs were associated with a reduced risk of failed procedures (RR=0.58, 95% CI 0.39 to 0.85, p=0.005). No significant heterogeneity was detected (I2=27%) among these trials. It further decreased first attempt to failure (RR=0.43, 95% CI 0.30 to 0.62, p<0.00001), mean attempts to success (SMD=-0.61, 95% CI -0.80 to -0.43, p=0.00001) and incidences of complications of headache and backache (RR=0.63, 95% CI 0.46 to 0.85, p=0.003). Ultrasound guidance is an effective technique for LPs in adults.
- Subjects
RANDOMIZED controlled trials; LUMBAR puncture; PARAVERTEBRAL anesthesia; PALPATION; ARTIFICIAL joints; PREGNANCY outcomes; OLDER patients; ULTRASONIC imaging; META-analysis; SYSTEMATIC reviews; SURGICAL complications
- Publication
Postgraduate Medical Journal, 2021, Vol 97, Issue 1143, p40
- ISSN
0032-5473
- Publication type
journal article
- DOI
10.1136/postgradmedj-2020-138238