Pain and Anxiety During Bone Marrow Biopsy

Betty Tanasale*, Jenne Kits, Philip M. Kluin, Albert Trip, Hanneke C. Kluin-Nelemans

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

14 Citaten (Scopus)

Samenvatting

A bone marrow biopsy is considered to be painful, often causing anxiety. We observed large differences between patients and wondered which factors cause pain and anxiety. In a prospective study, 202 patients were analyzed. Experienced hematologists and fellows in training (17% of biopsies) performed bone marrow aspirates and biopsies from the posterior iliac crest. Demographics, disease category, performance score, source of information, number of previous biopsies, experience of the hematologist, and length and quality of the biopsy were recorded. Pain and anxiety were measured using a visual analog scale and verbal rating score. Data were subjected to univariate and multivariate regression. The median pain score was 1.9 (range 0-10); 21% did not experience any pain. Anxiety scored 1.8 (range 0-10), and correlated positively with pain (p=.000). By univariate analysis, young age, poor performance, the physician as source of information, and prolonged procedures were associated with more pain. In multivariate analysis, anxiety, information from the physician, and a prolonged procedure persisted. Length or artifacts of the core biopsy did not correlate with pain. In conclusion, bone marrow biopsies performed in an optimal setting by experienced hematologists cause only mild pain, with, however, some patients experienced serious problems. To reduce pain, not only careful local anesthesia, but also the addition of systemic analgesics and especially anxiety reduction seems to be useful. (C) 2013 by the American Society for Pain Management Nursing

Originele taal-2English
Pagina's (van-tot)310-317
Aantal pagina's8
TijdschriftPain management nursing
Volume14
Nummer van het tijdschrift4
DOI's
StatusPublished - dec-2013

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