Pattern of pain management during lumbar puncture in children

Daniel Fein, Jeffrey R. Avner, Hnin Khine

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Background: Although studies have shown that children have similar physiological pain responses as adults, children often receive less pain medication compared with adults with similar painful conditions. The lumbar puncture is a painful procedure that historically has been commonly performed without local anesthesia, especially in young infants. Objective: The aim of the study was to determine what type of pain management, if any, pediatric patients received during lumbar puncture and whether its use varied by patient age. Methods: We performed a retrospective review of patients who had cerebrospinal fluid cultures obtained via lumbar puncture during 2003 at a large urban children's hospital. Eligible cases were reviewed for demographic data, hospital patient care area, and type of pain management used for the procedure. Results: Of the 353 children who had lumbar punctures performed, 84 (23.8%) received some form of pain management before their lumbar puncture. Sixty (17.0%) received local anesthesia, 43 (12.2%) received sedation, and 19 (5.4%) of these received both local anesthesia and sedation. Younger patients received pain management less frequently (P < 0.001): 16 (6.5%) of 246 neonates (0-2 months), 4 (14.3%) of 28 infants (3-18 months), 9 (60%) of 15 preschoolers (19-59 months), and 55 (85.9%) of 64 older children (60 months to 21 years). Among infants, patients treated in the emergency department received pain management more often than those treated in the nursery (13/103 [12.6%] vs 1/117 [0.9%]; P = 0.001). Conclusions: Despite advances in the awareness and attentiveness given to pain and pain management in the pediatric population, children are still not receiving satisfactory pain management for lumbar punctures.

Original languageEnglish (US)
Pages (from-to)357-360
Number of pages4
JournalPediatric Emergency Care
Issue number5
StatePublished - May 1 2010


  • Lumbar puncture
  • Pain management

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine


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