What are the steps for administering local anesthesia prior to a lumbar puncture (LP)?

Updated: Aug 02, 2018
  • Author: Gil Z Shlamovitz, MD, FACEP; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

Raise a skin wheal using the 25-gauge needle, then switch to the longer 20-gauge needle to anesthetize the deeper tissue. Insert the needle all the way to the hub, aspirate to confirm that the needle is not in a blood vessel, and then inject a small amount as the needle is withdrawn a few centimeters. Continue this process above, below, and to the sides very slightly (using the same puncture site).

Local anesthesia. Video courtesy of Gil Z Shlamovitz, MD.

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