Comparison of lumbar puncture location with bedside ultrasonography and palpation in adult patients admitted to the emergency room.

Amac: Lomber ponksiyon (LP) biyokimyasal, mikrobiyolojik ve sitolojik inceleme icin beyin omurilik sivisi orneginin alindigi tibbi bir islemdir. Calismamizda, LP'nin yerini belirlemede ultrasonografi (USG) yontemiyle palpasyon yontemini karsilastirmayi amacladik. Gerec ve Yontem: Calismaya 203 hasta dahil edildi. Calismada, Ultrasonografi (USG) sertifikasi olan 4. yilini tamamlayan ayni acil tip asistani tarafindan manuel veya USG ile yer belirtilmesi yapildi. Katilan hastalarda lomber ponksiyon yeri once USG, sonra manuel yontem ile belirlendi ve isaretlendi. Bulgular: USG yonteminin LP yerlesimini belirlemede manuel yontemden anlamli derecede daha basarili oldugu bulundu (p=0.012). LP bolgesinin belirlenmesinde, USG yontemi ozellikle oturma pozisyonunda, manuel yonteme gore anlamli olarak daha basarili oldugu bulunmustur (p=0.031). Diger pozisyonlarda iki grup arasinda fark gozlenmedi (Sag p=1, Sol p=0.500). Vucut Kitle Indeksi (VKI) USG ile alanin yer tayini sirasindaki basariyi etkiledi (p=0.0001). Benzer sekilde, vucut kitle indeksi, LP bolgesini manuel yontemle tanimlamadaki basariyi etkilemistir (p=0.0001). BMI>25 olan hastalarda LP alaninin belirlenmesinde USG yonteminin manuel yontemden anlamli derecede daha basarili oldugu bulundu (p=0.012). Sonuc: Palpasyon veya USG ile LP yer tayininde, vucut kitle indeksi arttikca, yer bulma suresi onemli olcude artmistir. LP yeri palpasyon ile belirlenemeyen hastalarda USG tarafindan tanimlanabilir. Ek olarak, USG, obez bireylerde LP sahasinin bulunmasi acisindan daha basarilidir.

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