Perceived levels of pain associated with bone marrow aspirates and biopsies.

Publication/Presentation Date

1-1-2012

Abstract

BACKGROUND: Little is known about the degree of pain experienced by patients undergoing a bone marrow aspiration and biopsy (BMAB).

OBJECTIVE: To evaluate the effectiveness of several strategies aimed at reducing the pain score.

METHODS: We conducted a retrospective analysis of 258 consecutive adult patients who underwent BMAB via 6 different approaches, the first 5 of which were performed by one physician. Group A received local anesthesia with 1% lidocaine hydrochloride (5 mL) and a 5-minute wait time before the procedure; group B received local anesthesia with a double dose (10 mL) of lidocaine; group C received 5 mL of local anesthesia with a 10-minute wait; group D received 5 mL of local anesthesia plus a topical spray with ethyl chloride; group E received oral analgesia and anxiolysis 30 minutes before the procedure in addition to the group A dosage of lidocaine; and group F received the same anesthesia as did group A, but the BMAD was performed by a less experienced practitioner.

RESULTS: On a 0 to 10 scale, the mean pain level among the 258 patients was 3.2 (standard deviation = 2.6). Rate of complications was low (

CONCLUSIONS: Given that the average level of perceived pain during BMAB is low to moderate (approximately 3 on a 0-10 scale), the routine use of conscious sedation for this procedure may not be indicated. Several strategies aimed at reducing the pain level, including doubling the dose of anesthesia and using an oral prophylactic regimen of analgesia and anxiolysis, failed to improve pain scores.

Volume

10

Issue

4

First Page

166

Last Page

170

ISSN

1544-6794

Disciplines

Medicine and Health Sciences

PubMedID

22621791

Department(s)

Department of Medicine, Hematology-Medical Oncology Division

Document Type

Article

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