Postinterventional pain and complications of sonographically guided interventions in the liver and pancreas.
OBJECTIVE
Sonographically guided interventions in abdominal organs are routine procedures with rare severe complications. However, potential patient discomfort or pain is frequently not addressed in the literature.


METHODS
In a prospective 1-year study, the peri- and postinterventional pain of patients undergoing sonographically guided punctures of the liver and pancreas was analyzed. Data acquisition was done with a standardized questionnaire. This included three numeric rating scales (NRS) ranging from "0" to "10" to be answered at puncture and 1 hour and 4 hours later. Data concerning complications and administered analgesic medication was acquired from the patients' charts.


RESULTS
223/274 patients could be analyzed (83 %). 91 women (40.8 %) and 132 men (59.2 %) were included. The mean age was 56.0 yrs. Overall the average level of pain was 2.98  at puncture, 1.21 after 1 hour and 0.71 after 4 hours. In patients with diagnostic biopsies, the pain levels were 3.37(0  h)/1.33(1  h)/0.71(4  h) for liver parenchyma, 2.64(0  h)/0.95(1  h)/0.65(4  h) for focal liver lesions and 3.1(0  h)/1.9(1  h)/1.1(4  h) for pancreatic punctures. The pain levels at therapeutic interventions were 3.00(0  h)/2.00(1  h)/0.50(4  h). Female and younger (< 50 yrs) patients had statistically significantly more pain at puncture and 1 hour postintervention. Only minor complications occurred (0.9 %).


CONCLUSIONS
Severe pain after sonographically guided interventions is rare. Most patients suffer only from mild pain postinterventionally.
Departement of Medicine 1, University of Erlangen.
A
A
Lindner
Departement of Medicine 1, University of Erlangen.
M
M
Frieser
Departement of Medicine 1, University of Erlangen.
R
R
Heide
Departement of Medicine 1, University of Erlangen.
D
D
Wildner
Departement of Medicine 1, University of Erlangen.
M F
MF
Neurath
Institut für Arbeitsmarkt- und Berufsforschung, Nuremberg.
W
W
Dauth
Departement of Medicine, Kreisklinik Ebersberg.
T
T
Bernatik
Departement of Medicine 1, University of Erlangen.
D
D
Strobel
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D001707:Biopsy, Needle / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D008100:Liver Abscess / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000209:etiology*; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology*; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology*; D011446:Prospective Studies; D012737:Sex Factors; D011795:Surveys and Questionnaires; D018084:Ultrasonography, Interventional / Q000009:adverse effects*; D055815:Young Adult
D000700:Analgesics