Pain and bleeding associated with trephine biopsy.
The study objectives were to determine the intensity and duration of pain, factors that may influence pain experience during and after trephine biopsy, and to assess bleeding and infectious complications related to the procedure. Patients scheduled for trephine biopsy were recruited to the study. Local anesthesia was applied in all patients. Pain intensity was recorded twice daily by the patients using the numeric rating scale (NRS). Bleeding was graded into four grades. Median age of 184 patients was 63 yr. Maximum NRS level was measured at time of biopsy (T0); 167 (91%) patients experienced pain at T0. Median (Q1:Q3) NRS was 3 (1; 5). Median duration of pain was 36 h. Fourteen patients reported pain for more than 7 d. Significant inverse correlation was found between NRS at T0 and age. Pain duration at rest correlated with NRS at T0 and age, while pain duration in activity correlated with NRS at T0, age, and with body mass index (BMI). Mild and moderate bleeding at T0 occurred in 97 (54%) and 18 (10%) patients, respectively; no severe bleeding or infectious complications were registered. Secondary bleeding occurred in two patients; both required hospitalization. In conclusion, the study shows that despite the application of local anesthetic, more than 50% of the patients experienced pain of ≥ 3 points. Procedure-related bleeding is mild to moderate and managed by local pressure only.
Department of medicine, Baerum hospital, Baerum, Norway; Department of medicine, Østfold Hospital trust, Fredrikstad, Norway.
Therese
T
Valebjørg
Boris
B
Spahic
Fredrik
F
Bremtun
Johannes
J
Kahrs
Jens
J
Hammerstrøm
Robert
R
Brudevold
Jan
J
Kolflaath
Waleed
W
Ghanima
D000368:Aged; D001706:Biopsy / Q000009:adverse effects*; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D010146:Pain / Q000175:diagnosis / Q000209:etiology*; D010147:Pain Measurement; D011446:Prospective Studies; D012307:Risk Factors; D057566:Self Report; D011795:Surveys and Questionnaires; D014207:Trephining / Q000009:adverse effects*
biopsy; bleeding; bone marrow; pain