Atraumatic (pencil-point) versus conventional needles for lumbar puncture: a clinical practice guideline

Bram Rochwerg; Saleh A Almenawer; Reed A C Siemieniuk; Per Olav Vandvik; Thomas Agoritsas; Lyubov Lytvyn; Waleed Alhazzani; Patrick Archambault; Frederick D'Aragon; Pauline Darbellay Farhoumand; Gordon Guyatt; Jon Henrik Laake; Claudia Beltrán-Arroyave; Victoria McCredie; Amy Price; Christian Chabot; Tracy Zervakis; Jetan Badhiwala; Maude St-Onge; Wojciech Szczeklik; Morten Hylander Møller; Francois Lamontagne

doi:10.1136/bmj.k1920

Atraumatic (pencil-point) versus conventional needles for lumbar puncture: a clinical practice guideline

Bram Rochwerg, Saleh A Almenawer, Reed A C Siemieniuk, Per Olav Vandvik, Thomas Agoritsas, Lyubov Lytvyn, Waleed Alhazzani, Patrick Archambault, Frederick D'Aragon, Pauline Darbellay Farhoumand, Gordon Guyatt, Jon Henrik Laake, Claudia Beltrán-Arroyave, Victoria McCredie, Amy Price, Christian Chabot, Tracy Zervakis, Jetan Badhiwala, Maude St-Onge, Wojciech SzczeklikMorten Hylander Møller, Francois Lamontagne

Department of Clinical Medicine

11 Citations (Scopus)

21 Downloads (Pure)

Abstract

Is the needle tip configuration important when performing a lumbar puncture for any indication? A systematic review published in the Lancet in December 2017 suggests that it is. The review found that using atraumatic (pencil-point) lumbar puncture needles instead of conventional lumbar puncture needles reduced the risk of post-dural-puncture headache and of return to hospital for additional pain control.¹ This guideline recommendation aims to promptly and transparently translate this evidence to a clinical recommendation, following standards for GRADE methodology and trustworthy guidelines.² The BMJ Rapid Recommendations panel makes a strong recommendation for the use of atraumatic needles for lumbar puncture in all patients regardless of age (adults and children) or indication instead of conventional needles.^{3 4} Box 1 shows the article and evidence linked to this Rapid Recommendation. The main infographic provides an overview of the absolute benefits and harms (although none were present here) of atraumatic needles. Table 1 below shows any evidence that has emerged since the publication of this guideline.

Original language	English
Article number	k1920
Journal	BMJ (Clinical research ed.)
Volume	361
Pages (from-to)	1-6
Number of pages	6
ISSN	0959-8146
DOIs	https://doi.org/10.1136/bmj.k1920
Publication status	Published - 2018

Keywords

Cost-Benefit Analysis
Equipment Design/economics
Humans
Needles/economics
Post-Dural Puncture Headache/prevention & control
Spinal Puncture/adverse effects

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Atraumatic (pencil-point) versus conventional needles for lumbar punctureFinal published version, 758 KBLicence: CC BY-NC

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Rochwerg, B., Almenawer, S. A., Siemieniuk, R. A. C., Vandvik, P. O., Agoritsas, T., Lytvyn, L., Alhazzani, W., Archambault, P., D'Aragon, F., Farhoumand, P. D., Guyatt, G., Laake, J. H., Beltrán-Arroyave, C., McCredie, V., Price, A., Chabot, C., Zervakis, T., Badhiwala, J., St-Onge, M., ... Lamontagne, F. (2018). Atraumatic (pencil-point) versus conventional needles for lumbar puncture: a clinical practice guideline. BMJ (Clinical research ed.), 361, 1-6. [k1920]. https://doi.org/10.1136/bmj.k1920

Rochwerg, B, Almenawer, SA, Siemieniuk, RAC, Vandvik, PO, Agoritsas, T, Lytvyn, L, Alhazzani, W, Archambault, P, D'Aragon, F, Farhoumand, PD, Guyatt, G, Laake, JH, Beltrán-Arroyave, C, McCredie, V, Price, A, Chabot, C, Zervakis, T, Badhiwala, J, St-Onge, M, Szczeklik, W, Møller, MH & Lamontagne, F 2018, 'Atraumatic (pencil-point) versus conventional needles for lumbar puncture: a clinical practice guideline', BMJ (Clinical research ed.), vol. 361, k1920, pp. 1-6. https://doi.org/10.1136/bmj.k1920

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title = "Atraumatic (pencil-point) versus conventional needles for lumbar puncture: a clinical practice guideline",

abstract = "Is the needle tip configuration important when performing a lumbar puncture for any indication? A systematic review published in the Lancet in December 2017 suggests that it is. The review found that using atraumatic (pencil-point) lumbar puncture needles instead of conventional lumbar puncture needles reduced the risk of post-dural-puncture headache and of return to hospital for additional pain control.1 This guideline recommendation aims to promptly and transparently translate this evidence to a clinical recommendation, following standards for GRADE methodology and trustworthy guidelines.2 The BMJ Rapid Recommendations panel makes a strong recommendation for the use of atraumatic needles for lumbar puncture in all patients regardless of age (adults and children) or indication instead of conventional needles.3 4 Box 1 shows the article and evidence linked to this Rapid Recommendation. The main infographic provides an overview of the absolute benefits and harms (although none were present here) of atraumatic needles. Table 1 below shows any evidence that has emerged since the publication of this guideline.",

keywords = "Cost-Benefit Analysis, Equipment Design/economics, Humans, Needles/economics, Post-Dural Puncture Headache/prevention & control, Spinal Puncture/adverse effects",

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AU - Vandvik, Per Olav

AU - Agoritsas, Thomas

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AU - Alhazzani, Waleed

AU - Archambault, Patrick

AU - D'Aragon, Frederick

AU - Farhoumand, Pauline Darbellay

AU - Guyatt, Gordon

AU - Laake, Jon Henrik

AU - Beltrán-Arroyave, Claudia

AU - McCredie, Victoria

AU - Price, Amy

AU - Chabot, Christian

AU - Zervakis, Tracy

AU - Badhiwala, Jetan

AU - St-Onge, Maude

AU - Szczeklik, Wojciech

AU - Møller, Morten Hylander

AU - Lamontagne, Francois

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AB - Is the needle tip configuration important when performing a lumbar puncture for any indication? A systematic review published in the Lancet in December 2017 suggests that it is. The review found that using atraumatic (pencil-point) lumbar puncture needles instead of conventional lumbar puncture needles reduced the risk of post-dural-puncture headache and of return to hospital for additional pain control.1 This guideline recommendation aims to promptly and transparently translate this evidence to a clinical recommendation, following standards for GRADE methodology and trustworthy guidelines.2 The BMJ Rapid Recommendations panel makes a strong recommendation for the use of atraumatic needles for lumbar puncture in all patients regardless of age (adults and children) or indication instead of conventional needles.3 4 Box 1 shows the article and evidence linked to this Rapid Recommendation. The main infographic provides an overview of the absolute benefits and harms (although none were present here) of atraumatic needles. Table 1 below shows any evidence that has emerged since the publication of this guideline.

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KW - Spinal Puncture/adverse effects

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M1 - k1920

ER -

Atraumatic (pencil-point) versus conventional needles for lumbar puncture: a clinical practice guideline

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Keywords

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