Bone marrow examination is useful in the diagnosis and staging of hematologic disease, as well as in the assessment of overall bone marrow cellularity. The procedure can be a difficult experience for the patient. Pain and anxiety may play a role in the experience. The purpose of the study was to assess practices for pain control in patients undergoing bone marrow biopsy at a private community hospital and to determine if pain medication before bone marrow biopsy impacts pain during and after the procedure.
Patients undergoing bone marrow biopsy at a 588‐bed community teaching hospital during a 1‐year period were included in a prospective cohort study. Patients were asked to rate their level of pain and anxiety before the procedure, their highest level of pain during the procedure, and their level of pain after the procedure. The visual analog scale was used for pain scores and the distress thermometer was used for anxiety scores. Patients who received some type of pain medication before the procedure were compared with patients who did not receive any type of medication before the procedure.
Eighty‐five patients were included in the study. The majority of patients (72%) received some type of pain medication before the procedure. Administration of pain medication throughout the various hospital sites was inconsistent. All patients receiving their bone marrow biopsy through the radiology department and the majority of patients (77%) undergoing bone marrow biopsy at inpatient bedside received pain medication before the procedure. However, only 30% of patients receiving their bone marrow biopsy at the outpatient cancer center received pain medication before the procedure. Furthermore, patients who received pain medication before the procedure experienced significantly lower pain during and after the procedure when compared with patients who received no pain medication. The average difference in the pain rating from before the procedure to the most pain experienced during the procedure was 2.9 for patients who received pain medication and 6.2 for patients who did not receive pain medication (P < 0.001). In addition, the average difference in the pain rating from before to after the procedure was 0.6 for patients who received pain medication and 2.2 for patients who did not receive pain medication (P = 0.01).
Currently, there is not a standard way of managing pain for patients undergoing bone marrow biopsies. Pain medication has a significant impact on pain experienced by the patient during and after the bone marrow biopsy. Increasing awareness by implementing a standardized protocol will likely improve patient care.
M. Ahmed ‐ none