Perceived levels of pain associated with bone marrow aspirates and biopsies.
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.
Published In/Presented At
Talamo, G., Liao, J., Joudeh, J., Lamparella, N. E., Dinh, H., Malysz, J., & Ehmann, W. C. (2012). Perceived levels of pain associated with bone marrow aspirates and biopsies. The journal of supportive oncology, 10(4), 166–170. https://doi.org/10.1016/j.suponc.2012.04.002
Medicine and Health Sciences
Department of Medicine, Hematology-Medical Oncology Division