Type and level of anxiety affects the perception of pain during bone marrow biopsy

Abstract

Objective: Bone marrow aspiration and biopsy (BMAB) is an essential tool for the diagnosis of hematological disorders. The most frequent complaint after BMAB is pain but the severity of this pain is described very different among patients. We investigated factors predicting this pain focusing on the role of state and trait anxiety. 
 
 Methods: One hundred and ten adult patients undergoing BMAB, were informed adequately and assessed with “The State-Trait Anxiety Inventory” (STAI) before the procedure. In this Likert-type inventory, State Anxiety Scale evaluates the current state of anxiety, asking how respondents feel “at that moment”. The Trait Anxiety Scale evaluates relatively stable aspects of “anxiety proneness,” including general states of confidence, calmness, and security. After the biopsy, the pain was measured with visual analog scale.
 
 Results: Most of the patients (71.8%) described mild pain but moderate to severe pain were significantly more frequent in both high state and trait anxiety groups. Pain severity had a positive but weak correlation with trait anxiety but not with state anxiety. The described pain level was associated with older age but was not with an indication of biopsy, performance status, comorbidities or previous BMAB experiences.
 
 Conclusion: Results of our study made us thought that a good communication with the
 patient and talking about possible outcomes days before procedure might play a role in reducing
 his or her anxiety but because age and trait anxiety cannot be changed by using fast-acting
 anxiolytic drugs, the advantage of premedication with anxiolytics in order of reducing pain,
 would be limited.