title: Frequency and intensity of pain related to thyroid nodule fine-needle aspiration cytology.
abstract: BACKGROUND
  Quality of life is an important issue in endocrine tumors because of the high prevalence of benign tumors and the indolent course of most malignant tumors.
  
  
  OBJECTIVE
  To evaluate the frequency and the intensity of pain and anxiety in patients undergoing thyroid nodule fine-needle aspiration cytology (FNAC) and to identify factors associated with pain.
  
  
  METHODS
  Single center prospective study in the setting of a one-stop outpatient diagnostic clinic for thyroid nodules. Pain was evaluated using a 100-mm visual analogue scale (VAS) immediately following (VAS1) and 30 minutes after (VAS2) FNAC and was considered significant if ≥ 30. Anxiety symptoms were assessed prior to FNAC using a self-report measure questionnaire: the state form of Spielberger State-Trait Anxiety Inventory (STAI, form Y-A). FNAC was performed with a 25-gauge needle and a moderate aspiration and two passes for each nodule.
  
  
  RESULTS
  Two hundred eighteen consecutive patients (163 females, 55 males; mean age 53 years, range 12-84 years) undergoing FNAC of one to three nodules were included. VAS1 was ≥ 30 in 24% of the patients and VAS(2) was ≥ 30 in 13% of the patients. Independent significant factors correlated to a VAS1 of ≥ 30 were age under 25 years and the number of nodules being biopsied. Independent significant factors correlated to a VAS2 of ≥ 30 were VAS1 ≥ 30 and female sex. No correlation was found between pain and nodule size or nodule depth, nor the duration of application of the eutectic mixture of local anesthetics (EMLA) patch prior to FNAC. The mean STAI score for anxiety was 37 ± 12. The average STAI score was significantly higher in women (39) than in men (33; p = 0.01). There was no significant correlation between STAI score and age under 25 years, previous FNAC, number of nodules biopsied, or acetaminophen administration, but the STAI score was significantly correlated to VAS1 and VAS2.
  
  
  CONCLUSIONS
  FNAC-related pain is frequent and correlates with the number of nodules biopsied, age under 25 years, female sex, and anxiety.
authors: 1 Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy, University Paris-Sud , Villejuif, France .
authors: Sophie
authors: S
authors: Leboulleux
authors: Isabelle
authors: I
authors: Borget
authors: Stéphanie
authors: S
authors: Labro
authors: Sophie
authors: S
authors: Bidault
authors: Philippe
authors: P
authors: Vielh
authors: Dana
authors: D
authors: Hartl
authors: Sarah
authors: S
authors: Dauchy
authors: Cécile N
authors: CN
authors: Chougnet
authors: Elizabeth
authors: E
authors: Girard
authors: Sandy
authors: S
authors: Azoulay
authors: Haitham
authors: H
authors: Mirghani
authors: Amandine
authors: A
authors: Berdelou
authors: Jean
authors: J
authors: Lumbroso
authors: Désirée
authors: D
authors: Deandreis
authors: Eric
authors: E
authors: Baudin
authors: Martin
authors: M
authors: Schlumberger
authors: Sophie
authors: S
authors: Laurent
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D019162:Anesthetics, Combined / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000627:therapeutic use; D001007:Anxiety / Q000209:etiology; D044963:Biopsy, Fine-Needle / Q000009:adverse effects*; D002648:Child; D005260:Female; D005602:France; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011318:Prilocaine / Q000627:therapeutic use; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013961:Thyroid Gland / Q000473:pathology*; D016606:Thyroid Nodule / Q000473:pathology*; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D000082:Acetaminophen; D008012:Lidocaine