Lumbar puncture (spinal) (EN) Lumbar puncture (spinal) (EN)

Lumbar puncture (spinal)

No eating or drinking before the operation

Your stomach must be empty for the operation. If you eat, stomach acid is produced. Under anaesthesia, this stomach acid can enter the lungs which may cause pneumonia. To prevent this, your stomach must be empty for surgery. This means that you may not eat or drink from a certain time. If you do eat or drink before the operation, the operation cannot take place.

No eating or drinking before the operation. This means:

Up to 6 hours before the admission time you may have a light meal only. You can choose from:

• 2 rusks/crackers with jam, no butter or;
• 1 slice of bread with jam, no butter.

Up to 2 hours before the admission time you may only drink clear liquids such as:

• coffee (without milk, sugar is allowed), tea, water, clear apple juice or uncarbonated lemonade;
• you may not drink dairy products or broth.

In the diagram below on the left side, you can find the time you are expected at the hospital (this is your admission time). Behind it, you can see from which time you may no longer eat and also from which time you may no longer drink.

Please note:
If you are admitted the day before your operation, you do not have to arrive with an empty stomach.

Can I take my medication before the operation?

If you are taking medication, the anaesthetist will discuss whether you can take it or if you must stop temporarily. If you take blood thinners, you may have to stop a few days before the operation. Your anaesthetist or the Thrombosis Service will tell you when to stop taking your blood thinners and when you can start again.

Shortly before the operation, we check if your health or medication use has changed. If your operation takes place at Isala Zwolle, you will receive a short list of questions on the day of your admission. If your operation takes place at Isala Meppel, we will call you one day before your admission.

The operation

You get painkillers about an hour before the operation. Then you are taken to the preparation room in the Operating Theatre where you are connected to various monitoring devices. You get an infusion in your arm to administer fluids and medication.

The anaesthetist asks you to sit down or lie down on your side and make your back hollow. With a very thin needle, the anaesthetist punctures the spinal cord and injects the anaesthetic. Once the anaesthetic has been injected, you first notice that your legs are getting warm and start tingling. Then they become numb and limp, just like the rest of your lower body.

You are awake during the operation. If you would prefer to sleep, ask for a sedative. Even if you are awake, you will not see the operation. The surgical area is blocked off by a screen.

After the operation

After the operation, it takes one to three hours before the anaesthetic is fully worn off. You will notice that it is wearing off when your legs start tingling. The movement comes back first and then the feeling.

Pain relief after the operation

It is important that you suffer from as little pain as possible after your operation so you will get pain relief. The anaesthetist and you have agreed on the type of pain relief you will receive. Below are the two types:

• Medication
  During your admission, you can get pain relief in the form of tablets, suppositories or via an infusion.
• PCA pump
  With a PCA pump, you can give yourself small amounts of pain-relieving medication. If you feel too much pain, you can press the button. PCA stands for Patient Controlled Analgesia.

Side effects and complications

The following side effects and complications may occur with a lumbar puncture:

• Low blood pressure. The anaesthetist monitors this and takes measures if necessary.
• Sometimes, the anesthetised area extends further upwards. Your hands may start to tingle. In rare cases, breathing can be more difficult. The anaesthetist then administers extra oxygen.
• You may feel nauseous. Report this, there is good medication for nausea.
• You may have difficulty urinating. Occasionally it may be necessary to empty the bladder with a catheter (tube).
• The spot where you received the spinal puncture may be somewhat sensitive. This will pass after a while. If you have back pain in another area, this may be because you were in the same position for a long time during the operation. This pain usually disappears within a few days.
• Headaches can also occasionally occur after a lumbar puncture. The headache can start immediately after the operation or only after 24 hours. Usually, this headache disappears within a week. If the symptoms are so severe that you have to stay in bed, you should contact the anaesthetist.

Going home

After you have had a lumbar puncture, your reflexes may be temporarily affected. If you are allowed to go home on the day of the operation make sure that you are not alone at home the first night after your discharge from the hospital. You may not drive home yourself. Make sure you have someone to take you home. You may also not operate dangerous machinery that day, and you should not make any important decisions.

Take it easy at home for the first 24 hours after the operation. Make sure you have enough painkillers such as paracetamol, ibuprofen or diclofenac at home. Please also follow the instructions given to you by the doctor who operated on you.

It is quite normal that you will not feel fit for some time after an operation. This is not only because of the lumbar puncture but also because an operation is a major event. The body must recover at its own pace.

Contact

If you have any questions, you can call:

Preoperative Examination
088 624 21 39 (available from Monday to Friday between 8:30 and 17:00)

If you can't make it, please let us know so we can make a new appointment.