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 (<1%). Several strategies failed to improve the pain level, including the administration of a double dose of local anesthesia, waiting longer for the anesthesia effect, and the additional use of a topical anesthetic spray or oral analgesia and anxiolysis. Pain levels were not increased when the procedure was done by a less experienced practitioner. Younger age and female gender were associated with higher pain levels. 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.

Original languageEnglish (US)
Pages (from-to)166-170
Number of pages5
JournalJournal of Supportive Oncology
Volume10
Issue number4
DOIs
StatePublished - Jul 1 2012

Fingerprint

Bone Marrow
Biopsy
Pain
Local Anesthesia
Needle Biopsy
Lidocaine
Analgesia
Anesthesia
Oral Sprays
Ethyl Chloride
Conscious Sedation
Local Anesthetics
Physicians

All Science Journal Classification (ASJC) codes

  • Oncology
  • Pharmacology (medical)

Cite this

Talamo, Giampaolo ; Liao, Jiangang (Jason) ; Joudeh, Jamal ; Lamparella, Nicholas E. ; Dinh, Hoang ; Malysz, Jozef ; Ehmann, W. Christopher. / Perceived Levels of Pain Associated with Bone Marrow Aspirates and Biopsies. In: Journal of Supportive Oncology. 2012 ; Vol. 10, No. 4. pp. 166-170.
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title = "Perceived Levels of Pain Associated with Bone Marrow Aspirates and Biopsies",
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 (<1{\%}). Several strategies failed to improve the pain level, including the administration of a double dose of local anesthesia, waiting longer for the anesthesia effect, and the additional use of a topical anesthetic spray or oral analgesia and anxiolysis. Pain levels were not increased when the procedure was done by a less experienced practitioner. Younger age and female gender were associated with higher pain levels. 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.",
author = "Giampaolo Talamo and Liao, {Jiangang (Jason)} and Jamal Joudeh and Lamparella, {Nicholas E.} and Hoang Dinh and Jozef Malysz and Ehmann, {W. Christopher}",
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Perceived Levels of Pain Associated with Bone Marrow Aspirates and Biopsies. / Talamo, Giampaolo; Liao, Jiangang (Jason); Joudeh, Jamal; Lamparella, Nicholas E.; Dinh, Hoang; Malysz, Jozef; Ehmann, W. Christopher.

In: Journal of Supportive Oncology, Vol. 10, No. 4, 01.07.2012, p. 166-170.

Research output: Contribution to journalArticle

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T1 - Perceived Levels of Pain Associated with Bone Marrow Aspirates and Biopsies

AU - Talamo, Giampaolo

AU - Liao, Jiangang (Jason)

AU - Joudeh, Jamal

AU - Lamparella, Nicholas E.

AU - Dinh, Hoang

AU - Malysz, Jozef

AU - Ehmann, W. Christopher

PY - 2012/7/1

Y1 - 2012/7/1

N2 - 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 (<1%). Several strategies failed to improve the pain level, including the administration of a double dose of local anesthesia, waiting longer for the anesthesia effect, and the additional use of a topical anesthetic spray or oral analgesia and anxiolysis. Pain levels were not increased when the procedure was done by a less experienced practitioner. Younger age and female gender were associated with higher pain levels. 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.

AB - 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 (<1%). Several strategies failed to improve the pain level, including the administration of a double dose of local anesthesia, waiting longer for the anesthesia effect, and the additional use of a topical anesthetic spray or oral analgesia and anxiolysis. Pain levels were not increased when the procedure was done by a less experienced practitioner. Younger age and female gender were associated with higher pain levels. 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.

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