Evidence map›Paper›PMID 41626414›Full record

ArticlePaediatrics & child health2025

Pain management strategies for lumbar puncture in infants ≤6 months: A systematic review and meta-analysis.

Nevart Chirinian, Najla Tabbara, Anna Taddio, Elizabeth Uleryk, Vibhuti Shah

Abstract read
In one paragraph

Article in Paediatrics & child health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Nevart ChirinianDepartment of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada.
Najla TabbaraDepartment of Pharmacy, Mount Sinai Hospital, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0002-8370-0381
Anna TaddioLeslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0003-4432-8975
Elizabeth UlerykE.M. Uleryk Consulting, Mississauga, Ontario, Canada.
Vibhuti ShahDepartment of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0001-8685-2447

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Lumbar puncture (LP) is a painful procedure performed in infants. Both national and international organizations recommend the use of local anesthetics for LP pain management. However, recommendations are not based on systematic review of the literature. The primary objective of this systematic review and meta-analysis was to synthesize the literature on local anesthetics and opioids for pain management in infants undergoing LP. Methods: Databases were searched for randomized trials from inception to March 2024. The literature search was updated in June 2025 and no additional eligible articles were identified for inclusion. Title and abstract screening, full-text screening and data extraction were performed in duplicate. Risk of bias was assessed using Cochrane's risk of bias (RoB) 2.0 tool. The critically important outcome was pain measured using validated tools including unidimensional behaviour and multidimensional (comprising combinations of contextual, behavioural and/or physiological components) tools. Secondary outcomes included procedure success and adverse events. Pooled effect estimates were standardized mean difference (SMD) and relative risk (RR) with 95% confidence intervals (CI) using random effects models. A GRADE assessment of the overall certainty of the evidence for each outcome was completed. Results: Five studies with 292 infants were included. The interventions evaluated include local anesthetics (subcutaneous injection of lidocaine, needle-free jet injection of lidocaine using J-Tip and topical administration of lidocaine-prilocaine) and opioids (intravenous fentanyl). Local anesthetics were effective in reducing acute pain compared to placebo/control (SMD -0.70 [95% CI -0.89, -0.51]; I Discussion: Both local anesthetics and opioids are effective in reducing pain associated with LP based on limited evidence and can be incorporated in clinical practice. Future studies should evaluate the effectiveness and safety of combined analgesia and alternative routes of administration for opioids.

Indexed as

Infant-newbornLumbar puncturePain management

Identifiers

PMID41626414
PMCPMC12856196

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.