Patients’ misperception regarding the difficulty of lumbar puncture

Abstract

Aim: Lumbar puncture (LP) is a crucial method of diagnosis and treatment of neurological diseases. Despite its importance, the patients' refusal of the procedure leads to difficulties in diagnosis and treatment. One of the main reasons for patients’ refusal may be that LP is perceived to be more difficult than it actually is. Our aim was to investigate whether the patients had prejudices against the difficulty of LP treatment.

Methods: Sixty-seven patients aged between 20 and 80 years were included in to the study. Immediately prior to the procedure, each patient was asked to rate the difficulty level of the operation with the Visual Analog Scale (VAS) as 0 very easy to 10 very difficult. The cause of the LP, pre-diagnosis, education status, age and sex, presence of complications and the title of the physician performing the LP were recorded.

Results: A total of 20 patients refused the procedure (29.3%).  Of the 47 patients, who had the procedure performed, 21 were female and 26 were male. Twenty-seven LP were performed by first-year assistant and 21 were performed by second-year assistant. Patients' mean VAS scores before the LP were 7.9 ± 2.0 and were 4.1 ± 2.9 after the LP. Post-procedure VAS scores were significantly lower than pre-procedural VAS scores (p <0.001). The mean value of the VAS scores of the patients, whose LPs were performed by 1st year assistant, was 5.6±3.2 and the mean value of the VAS scores of the patients, whose LPs were performed by 2nd year assistant, was 3±2.2. There was a significant difference between two patient groups (p=0.004).

Conclusions: The patient perception of the lumbar puncture is perceived to be worse than it actually is. Therefore, it is very important to provide sufficient information to the patients about the LP and to inform them about the necessity of the procedure.