Effective pain reduction during bone marrow biopsy and aspiration – Technique over experience

Background: Bone marrow biopsy and aspiration (BMBA) is a diagnostic procedure within the field of internal medicine. The intensity of the pain felt by the patients often goes unrecognized by the medical staff. No extant studies have addressed pain intensity experienced during each particular step of a BMBA. Objectives: The aim was to analyze the pain intensity and explore the extent to which the technique applied by the doctor performing the biopsy influences the pain level. Methods: A survey comprising 17 questions was created and it addressed characteristics of the patients, previous experience and pain intensity on each step of the procedure. Results: 125 patients were enrolled into the study. Age (p = 0.009), gender (p = 0.02), pain during previous biopsies (p < 0.0001) and adequate information (p = 0.04) were shown to have significant impact on the pain intensity levels. There was a significant difference in the pain levels on different steps of the procedure perceived by the patients, when comparing the doctors with similar experience performing BMBA (p = 0.01 to p < 0.0001 depending on the step of the procedure). Conclusions: The differences in the pain scores between the doctors are most likely caused by differences in technique of BMBA. The analysis of the individual technique of the doctors performing the least painful biopsies may give answers needed for educational intervention aimed at pain reduction during BMBA.