Prevalence and characteristics of pain induced by percutaneous liver biopsy.
Percutaneous needle liver biopsy is an important procedure for the diagnosis and evaluation of liver disease and is frequently associated with pain. In this prospective study, we investigated the prevalence and characteristics of this pain syndrome. Fifty-four subjects, who underwent liver biopsy under ultrasound guidance, received 5 mg of diazepam orally 1 h before the procedure and local infiltration with 10 mL of 2% lidocaine just before needle insertion. Outcome measures included the visual analog scale for measuring pain intensity over 24 h, pain localization on a body scheme, and the Spielberger questionnaire for measuring anxiety levels. Forty-seven (84%) of the 54 respondents reported pain 30 min after the biopsy (visual analog scale, 4.2 +/- 0.5; mean +/- SEM), and 21 (39%) reported pain at the 24-h time point. Biopsy site pain was reported by 9 subjects, right shoulder pain by 14, and pain at both sites by 24. Higher pain intensities were reported by women and by subjects with higher anxiety levels. This study indicates that liver biopsy is a painful condition in most patients. Mild anxiolytic treatment plus local anesthetic infiltration seem to produce insufficient analgesia, thus indicating that a more profound analgesic treatment is required for better control of this pain.


CONCLUSIONS
Percutaneous liver biopsy is a painful procedure in most patients. Mild anxiolytic treatment plus local anesthetic infiltration seem to produce insufficient analgesia. A more profound analgesic treatment is required for better control of this pain.
Eisenberg
E
E
Pain Relief Unit, Liver Unit and Department of Medical Imaging, Rambam Medical Center and the B. Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel.
Konopniki
M
M
Veitsman
E
E
Kramskay
R
R
Gaitini
D
D
Baruch
Y
Y
D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D001007:Anxiety / Q000188:drug therapy / Q000523:psychology; D001706:Biopsy / Q000009:adverse effects*; D003975:Diazepam / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology* / Q000209:etiology; D010147:Pain Measurement; D011446:Prospective Studies; D011795:Surveys and Questionnaires
D000779:Anesthetics, Local; D014151:Anti-Anxiety Agents; D008012:Lidocaine; D003975:Diazepam