Oral analgesia and anxiolysis for pain associated with bone marrow biopsy

Abstract

20605 Background: Bone Marrow aspiration and biopsy (BMAB) is an invasive procedure commonly performed for the diagnosis of blood disorders and solid tumors. We evaluated the effectiveness of a combination of oral analgesics and minimal sedation (anxiolysis) in reducing the pain score of patients undergoing BMAB. Methods: Our study was retrospective and non-randomized. Seventy-eight consecutive adult patients (pts) underwent BMAB performed by a single physician in the left posterior superior iliac crest, using 5 mL of lidocaine HCl 1% solution (= 50 mg total dose) as local anesthesia in all pts. Thirty-three pts received preemptive analgesia with acetaminophen 650 mg and oxycodone 10 mg, and concomitant anxiolysis with lorazepam 2 mg. Drugs were given orally 30 minutes before the procedure. To assess the degree of pain, we used the Wong-Baker Faces Pain Rating Scale, which distinguishes 11 levels of pain, from 0 to 10. Results: The median pain level of the overall group was 3.5 (± 2.8). Among 45 pts treated with local anesthesia alone, median pain level was 4.0 (range 0–10, SD 2.9), and among 33 pts treated with additional analgesia and anxiolysis, median pain level was 2.9 (range 0–10, SD 2.3) (p>0.05). Statistical analysis did not find a correlation between pain score and several factors, including age, sex, weight, and length of specimen. No hemodynamic or respiratory complications were observed in the group receving analgesia and anxiolysis. Conclusions: The preemptive use of oral lorazepam, acetaminophen, and oxycodone, at the above doses, did not produce a clinically significant reduction of the perception of pain during BMAB. No significant financial relationships to disclose.