How to perform lumbar puncture in a newborn

When it comes to lumbar puncture, many people may feel scared because just hearing the name is a bit annoying. Given the current state of society, many people may think that lumbar puncture is used to treat adults. Indeed, lumbar puncture is a good treatment method, but there are still misunderstandings about age. Lumbar puncture can also be performed on newborns. Here I will tell you what are the methods of lumbar puncture for newborns?

The patient is usually in a bent side-lying position and puncture is performed at the L3-4 or L4-5 intervertebral space. After routine local disinfection and anesthesia, wear rubber gloves and slowly insert the puncture needle (or pediatric scalp needle) along the spinous process. When the needle is about 1.5-3cm in, there will be two breakthrough sensations. Pull out the needle core to let the cerebrospinal fluid flow out. After measuring the pressure and slowly releasing the fluid (no more than 2-3ml), put the needle core back in and pull out the puncture needle. Apply slight pressure to the puncture site to stop bleeding, apply sterile gauze and secure with tape. Lie flat for 4-6 hours after surgery. If the initial pressure exceeds 2.94 kPa (300 mm water column), it is not advisable to drain the fluid. Only the cerebrospinal fluid in the pressure measuring tube needs to be sent for cell counting and protein quantification.

1. Ask the child to lie on his side on a hard bed with his back perpendicular to the bed, his head forward and his chest bent, and his hands holding his knees close to his abdomen to make his trunk arched. Alternatively, an assistant can hold the patient's head with one hand opposite the operator and the other hand holding the fossa of both lower limbs and holding them tightly to make the spine kyphotic so as to widen the intervertebral space and facilitate needle insertion.

2. Determine the puncture point, which is the intersection of the line connecting the posterior superior iliac spine and the posterior midline. Generally, the puncture point is located between the 3rd-4th or 4th-5th lumbar spinous processes. The baby's position should not be too high.

The method of neonatal lumbar puncture is a very common treatment method. Lumbar puncture may be a little painful for children, so adults should pay special attention to their emotions. In addition, special attention should be paid to the care of children after lumbar puncture. If any abnormalities occur after surgery, you should see a doctor promptly.