During lumbar puncture, if there is increased intracranial pressure, papilledema, and the condition requires puncture, how to deal with it (preoperative, intraoperative, postoperative)

Lumbar puncture is relatively contraindicated in patients with intracranial hypertension, and the main risk of doing lumbar puncture is the possibility of brain herniation. Others are rare. A lumbar puncture can be performed with caution if it is absolutely necessary and some tests are needed. 1. Prophylactic hypertonic dehydrating agents such as mannitol or diuretics can be given to reduce intracranial hypertension if necessary before surgery. Provide targeted psychological counseling to patients with anxiety. 2. Do not release fluid too quickly during the operation, and stop the fluid release when the intracranial pressure is found to be high. 3. Instruct the patient to strictly abide by the bed rest system after surgery, and pay attention to changes in consciousness, respiration, pulse, blood pressure, pupil and limb movements within 12 to 24 hours. If necessary, prophylactic dehydrating diuretics can be used as appropriate to prevent the formation or aggravation of brain herniation. If it happens, cardiopulmonary resuscitation should be taken immediately.

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