162: Evaluation of a Powered Intraosseous Device for Bone Marrow Sampling

Abstract

The importance of bone marrow examination in the evaluation of leukemia, multiple myeloma, anemia, pancytopenia, and other disorders is well established. The objective for this study was to evaluate the ability of a powered bone marrow aspiration device to penetrate the intraosseous medullary space of the iliac crest, and to aspirate bone marrow samples for the ultimate purpose of diagnosing disease and monitoring the course of disease and medical therapy. The device was used to obtain bone marrow samples in accordance with accepted practice guidelines and device's directions for use. Among other data, insertion success, time to insertion, and complications were recorded. Patient pain levels were rated from 0 to 10 (10=extreme pain). Device operators rated the use of the device from 0 to 10 (10=outstanding). There were 55 patients in the study from three centers. Successful insertion and aspiration of bone marrow samples were achieved in 54 of the 55 patients (98.1%). Mean insertion time was 4.9 ± 3.0 seconds; significantly faster than the 7.3 minutes reported by Kuball et al∗ (one-sample t-test, p < 0.001). There were no complications. The mean insertion pain score was 2.5 ± 2.2 and the mean aspiration pain score was 3.7 ± 2.5. On a scale of 0 to 10, the six operators rated the ease of use of the device at a mean score of 8.3 ± 1.7. Findings suggest that the powered aspiration device is safe and effective for bone marrow aspirations; and that through the use of powered device, needle placement time can be reduced—thereby reducing patient pain.∗ Kuball J, Schüz J, Gamm H, Weber M. Bone marrow punctures and pain. Acute Pain 2004;6(1):9–14. The importance of bone marrow examination in the evaluation of leukemia, multiple myeloma, anemia, pancytopenia, and other disorders is well established. The objective for this study was to evaluate the ability of a powered bone marrow aspiration device to penetrate the intraosseous medullary space of the iliac crest, and to aspirate bone marrow samples for the ultimate purpose of diagnosing disease and monitoring the course of disease and medical therapy. The device was used to obtain bone marrow samples in accordance with accepted practice guidelines and device's directions for use. Among other data, insertion success, time to insertion, and complications were recorded. Patient pain levels were rated from 0 to 10 (10=extreme pain). Device operators rated the use of the device from 0 to 10 (10=outstanding). There were 55 patients in the study from three centers. Successful insertion and aspiration of bone marrow samples were achieved in 54 of the 55 patients (98.1%). Mean insertion time was 4.9 ± 3.0 seconds; significantly faster than the 7.3 minutes reported by Kuball et al∗ (one-sample t-test, p < 0.001). There were no complications. The mean insertion pain score was 2.5 ± 2.2 and the mean aspiration pain score was 3.7 ± 2.5. On a scale of 0 to 10, the six operators rated the ease of use of the device at a mean score of 8.3 ± 1.7. Findings suggest that the powered aspiration device is safe and effective for bone marrow aspirations; and that through the use of powered device, needle placement time can be reduced—thereby reducing patient pain. ∗ Kuball J, Schüz J, Gamm H, Weber M. Bone marrow punctures and pain. Acute Pain 2004;6(1):9–14.