Procedural pain and serious adverse events following Bone Marrow Aspiration and Biopsy: Experience from an academic center in India

Abstract

Background: The bone marrow aspiration and biopsy (BMAB) is an important and frequent investigative procedure for hematological diseases. Although thought to be safe and well tolerated; data is limited on the complications and degree of pain experienced by patients undergoing BMAB. Further scarce is data from India and other regions from the developing world especially given the evidence that cultural factors that could shape pain perception. Adverse events following bone marrow biopsy are rare but poorly documented. Aims: To estimate the level of pain and frequency of serious adverse events experienced by patients undergoing BMAB at our center. We also attempted to identify factors associated with increased pain perception.Methods: Study setting: This study was conducted at a tertiary level teaching hospital, the Christian Medical College & Hospital, Ludhiana. Ethics approval was obtained from the Institutional research committee (CMC/1495).Study period: 01 April 2015 through 30 Nov 2019Study Design: This is a comparative cross-sectional study where comparison of those with relatively more pain to those with less was done to elicit the factors associated with pain perception. Results: A total of 942 BMAB procedures were performed in this period ( Table1). The major serious adverse event was hemorrhage, which comprised 2 of the 9 serious adverse events. The following risk-factors were associated with increased pain on Multivariate analysis: those with prior BMAB had very low odds of pain (OR (95 % CI): 0.23 (0.15–0.37)). However, when more than one attempt of biopsy was made the odds of pain was much higher (OR (95 % CI): 1.62 (1.29–2.05)). Conclusions: In our analysis BMAB is safe and associated with a low level of perceived pain. Serious adverse events following BMAB are rare, but can have considerable impact on the individual patient.