Combined Oral Administration of Analgesia and Anxiolysis for Pain Associated with Bone Marrow Aspiration and Biopsy

Cerchione, Claudio; Picardi, Marco; Pugliese, Novella; Pepa, Roberta Della; Gravetti, Angela; Casoria, Aniello; Nappi, Davide; Ciancia, Giuseppe; Pane, Fabrizio; Martinelli, Vincenzo

doi:10.1016/j.clml.2018.07.260

Cited by 3 publications

(4 citation statements)

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“…Even though the bone marrow aspiration and biopsy procedure was developed in the 19th century, patients continue to report pain, suggesting that the management of this pain has not evolved over time (Hjortholm et al, 2013). Local anesthesia with lidocaine is unable to alleviate all pain during this procedure or the anticipatory anxiety related to recalling the pain thereafter (Cerichione et al, 2017).…”

Section: Review Of the Literaturementioning

confidence: 99%

Use of Virtual Reality to Distract From Pain and Anxiety

Glennon¹,

McElroy²,

Connelly³

et al. 2018

ONF

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Section: Review Of the Literaturementioning

confidence: 99%

Use of Virtual Reality to Distract From Pain and Anxiety

Glennon¹,

McElroy²,

Connelly³

et al. 2018

ONF

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“…[30][31][32][33] A strong correlation has been identified between anxiety and the intensity of pain, even anxiety can be assured as a predictor of pain. 25,26,[34][35][36][37] This is important since this procedure is recurrent during the treatment and surveillance phase; painful previous experiences have been observed to cause more anticipatory anxiety, making subsequent approaches equal or more painful. 27 Anxiety in BMBA may be related to the procedure itself or the results of this.…”

Section: Anxiety As a Predictor Of Painmentioning

confidence: 99%

Psychological interventions for pain and anxiety management during bone marrow aspiration and biopsy

et al. 2023

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Cancer is the second cause of death in the world and the fourth in Mexico, among its types are onco-hematological diseases. Having cancer will have several repercussions on people suffering from it, including having to undergo very painful medical-invasive procedures, such as aspiration and bone marrow biopsy, a gold standard for the diagnosis of these pathologies. Bone marrow aspiration and biopsy anxiety is common, which increases pain and makes it a traumatic experience. Pharmacological strategies have not been entirely effective when it comes to pain management, so other solutions such as psychological interventions have been sought (psychoeducation, mindfulness and distraction techniques such as music therapy, self-directions, breathing techniques and relaxation use of virtual reality and mobile applications). Psychological interventions have been shown to be effective in managing pain and anxiety, however, for patients to have access to them, it is necessary to include the psychologist as part of the multidisciplinary team during the performance of these procedures.

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“…These have included the use of inhalational anesthetics like nitrous oxide, analgesics like opioids, sedatives, and also anxiolytics like benzodiazepines or a combination of these. 4,5 But, despite that, there is no clear consensus whether any of these interventions provide added benefit and if they do, to what extent. This necessitates further trials with these agents in different populations and settings to clarify and to be able to start broad use of any of these interventions.…”

Section: Introductionmentioning

confidence: 99%

“…Oral opioids like oxycodone and tramadol have been used in small populations and been found to be useful in significantly reducing the pain associated with this procedure in the adult population. 4 Tramadol is a synthetic, centrally acting analgesic with dual mode of action. It is a weak mu opioid agonist and an inhibitor of noradrenaline and serotonin uptake.…”

Section: Introductionmentioning

confidence: 99%

A Pilot Study on the Addition of Tramadol or Eutectic Mixture of Local Anesthetics (Prilocaine Plus Lignocaine) to Local Lignocaine Infiltration for Prevention of Bone Marrow Aspiration/Biopsy Associated Pain

Rudresha

Sansar

Lokanath

et al. 2021

South Asian J Cancer

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Objectives Bone marrow aspiration although being a common procedure is associated with significant pain and its reduction remains an unmet need. We evaluated the use of tramadol and eutectic mixture of local anesthetics (prilocaine plus lignocaine) (EMLA) for reducing the severity of pain. Materials and Methods In this pilot study, we compared the addition of either tramadol 50 mg per oral (T) or EMLA local application (E) or no intervention (L) in addition to the usual procedure of local infiltration with lignocaine 2% before bone marrow aspiration and biopsy (BMAB) in adults suspected/confirmed with malignancy. Both, tramadol and EMLA were administered 1 hour prior to the procedure. Primary end point was reduction in pain intensity with these interventions compared with local infiltration alone. Pain was assessed using numerical FACES pain scale, a visual analogue scale. Secondary end points were to see the effect on pre procedure apprehension and to find out the other factors associated with increased pain related to the procedure. Statistical Analysis and Results A total of 300 patients were included in the study, 100 each in tramadol (T), EMLA (E), and only lignocaine local infiltration (L) arms, respectively. The mean pain intensity on the visual scale was significantly lower in the tramadol arm (T, E, L—3.4, 4.4, 4.7, respectively) (p < 0.0005). There was a significant reduction in percentage of patients who experienced moderate/severe pain (four or more) in the tramadol arm (T, E, L—45, 77, 82%, respectively) (p < 0.0005). Duration of procedure >10 minutes, body mass index >30, ECOG (Eastern Oncology Group) performance status ≥3, and age >50 years were positively correlated with more pain. Leukemia patients experienced significantly more pain compared with patients with lymphoma and other solid malignancies. Tramadol was well tolerated. No significant effect on pre-procedure apprehension was noted in any of the arms. Conclusion Tramadol appears to have a preventive effect on bone marrow aspiration/biopsy-associated pain and appears to be well tolerated, whereas EMLA was not associated with such an effect. Larger studies may be done to ascertain the same.

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Combined Oral Administration of Analgesia and Anxiolysis for Pain Associated with Bone Marrow Aspiration and Biopsy

Cited by 3 publications

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Use of Virtual Reality to Distract From Pain and Anxiety

Use of Virtual Reality to Distract From Pain and Anxiety

Psychological interventions for pain and anxiety management during bone marrow aspiration and biopsy

A Pilot Study on the Addition of Tramadol or Eutectic Mixture of Local Anesthetics (Prilocaine Plus Lignocaine) to Local Lignocaine Infiltration for Prevention of Bone Marrow Aspiration/Biopsy Associated Pain

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