A positioning pillow to improve lumbar puncture success rate in paediatric haematology-oncology patients: a randomized controlled trialReport as inadecuate

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BMC Cancer

, 9:21

First Online: 15 January 2009Received: 27 May 2008Accepted: 15 January 2009DOI: 10.1186-1471-2407-9-21

Cite this article as: Marec-Bérard, P., Bissery, A., Kebaïli, K. et al. BMC Cancer 2009 9: 21. doi:10.1186-1471-2407-9-21


BackgroundLumbar punctures LPs are common in children with cancer. Although pain management during the lumbar puncture has been well standardized, dealing with stress and anxiety is not well addressed yet. Our objective was to evaluate the potential improvement of the LP success rate using a positioning pillow, to ensure maximum lumbar flexion, and allow paravertebral muscles to relax, in children who are awake, with either conscious sedation or no sedation.

MethodsChildren aged 2–18 years undergoing LP were randomly assigned to a positioning pillow or no intervention. The primary outcome was the rate of success, i.e. achieving the LP sampling or injection at the first attempt, without bleeding RBC < 50-mm. The secondary outcomes included: the child-s pain, assessed by a self-administered visual analogical scales VAS for children over 6 years of age; the parents- and caregivers- perception of the child-s pain; the satisfaction of the children, the parents, the caregivers and the physician. The child-s cooperation and the occurrence of post-LP syndrome were also evaluated.

Results124 children 62 in each group were included. The LP pillow tended to increase the success rate of LPs 67% vs. 57%, p = 0.23, and decreased the post-LP syndromes 15% vs. 24%, p = 0.17 but the differences were not statistically significant. In children over 6-year of age n = 72, the rate of success was significantly higher in the pillow group 58.5% vs. 41.5%, p = 0.031, with a tendency to feel less pain median VAS 25 vs. 15 mm, p = 0.39 and being more satisfied 84.4% vs. 75.0%, p = 0.34.

ConclusionOverall results do not demonstrate a benefit in using this pillow for lumbar punctures. This study results also suggest a benefit in the sub group of children over 6-year of age; this result needs confirmation.

Trial RegistrationThe trial was registered with Clinical Trials.gov number NCT00775112.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2407-9-21 contains supplementary material, which is available to authorized users.

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Author: Perrine Marec-Bérard - Alvine Bissery - Kamila Kebaïli - Matthias Schell - Françoise Aubert - Ségolène Gaillard - Murie

Source: https://link.springer.com/

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