Contributions
Abstract: PB2379
Type: Publication Only
Background
The bone marrow aspiration and biopsy (BMAB) is an important and frequent investigative tool for hematological disorders. It serves an important role in establishing diagnosis and prognosis. Although thought to be safe and well tolerated; little is known about the complications and degree of pain experienced by patients undergoing BMAB.
Aims
We attempted to estimate the frequency of serious adverse events and level of pain and experienced by patients undergoing BMAB at our centre.
Methods
We conducted a prospective analysis on patients who underwent BMAB from January 2015 through December 2017 at our tertiary care centre. An informed consent was taken pre-procedure. The procedure was performed by variable operators namely; consultant, residents and physician assistants. All patients where premedicated with tramadol intravenous pre procedure and the preferred approach was from the posterior superior iliac (PSIS) approach through a left lateral approach. Post procedure each patient was asked to define the pain by the Wong-Baker grimace scale. In the day care setting; the patient was observed for upto 60 minutes prior to being sent home. A serious adverse event was considered as one requiring a prolonged observation beyond routine practice or leading to or extending of admission to manage adverse events following and related to the BMAB.
Results
A total of 665 BMAB procedures were performed in this period ( Table1). The most frequent indication was for staging of lymphoma in 171(26.2%) patients. Sixteen patients (2.4%) did not report any pain. Four serious adverse events were reported, representing 0.6% of total reported procedures. The major serious adverse event was haemorrhage, which comprised 2 of the 4 serious adverse events. Both the haemorrhage event related to a posterior Ilial Artery psedoaneurysm. One was managed conservatively while the second one required surgical excision of the retroperitoneal hematoma and ligation of right internal iliac artery. Remainder events related to persistent vomiting and severe aching pain in the ipsilateral leg. There was no difference in pain levels [2 (1-10)] or significant complications when performed by variable operators, P>0.05. Patients who experienced greater pain (Pain score > 3) had a longer duration and more than two attempts to complete the BMAB.
Conclusion
In our analysis BMAB is associated with a low level of perceived pain and complications. The procedure appears relatively safe and the level of pain and attempts do not appear related to the operator. Current strategy appears effective and the further attempts to control pain for this procedure may not be indicated.Serious adverse events following BMAB though rare, but nevertheless can have considerable impact on individual patients.There is a potential for dangerous adverse events following BMAB.
Session topic: 36. Quality of life, palliative care, ethics and health economics
Keyword(s): Bone marrow biopsy, Complications, Pain
Abstract: PB2379
Type: Publication Only
Background
The bone marrow aspiration and biopsy (BMAB) is an important and frequent investigative tool for hematological disorders. It serves an important role in establishing diagnosis and prognosis. Although thought to be safe and well tolerated; little is known about the complications and degree of pain experienced by patients undergoing BMAB.
Aims
We attempted to estimate the frequency of serious adverse events and level of pain and experienced by patients undergoing BMAB at our centre.
Methods
We conducted a prospective analysis on patients who underwent BMAB from January 2015 through December 2017 at our tertiary care centre. An informed consent was taken pre-procedure. The procedure was performed by variable operators namely; consultant, residents and physician assistants. All patients where premedicated with tramadol intravenous pre procedure and the preferred approach was from the posterior superior iliac (PSIS) approach through a left lateral approach. Post procedure each patient was asked to define the pain by the Wong-Baker grimace scale. In the day care setting; the patient was observed for upto 60 minutes prior to being sent home. A serious adverse event was considered as one requiring a prolonged observation beyond routine practice or leading to or extending of admission to manage adverse events following and related to the BMAB.
Results
A total of 665 BMAB procedures were performed in this period ( Table1). The most frequent indication was for staging of lymphoma in 171(26.2%) patients. Sixteen patients (2.4%) did not report any pain. Four serious adverse events were reported, representing 0.6% of total reported procedures. The major serious adverse event was haemorrhage, which comprised 2 of the 4 serious adverse events. Both the haemorrhage event related to a posterior Ilial Artery psedoaneurysm. One was managed conservatively while the second one required surgical excision of the retroperitoneal hematoma and ligation of right internal iliac artery. Remainder events related to persistent vomiting and severe aching pain in the ipsilateral leg. There was no difference in pain levels [2 (1-10)] or significant complications when performed by variable operators, P>0.05. Patients who experienced greater pain (Pain score > 3) had a longer duration and more than two attempts to complete the BMAB.
Conclusion
In our analysis BMAB is associated with a low level of perceived pain and complications. The procedure appears relatively safe and the level of pain and attempts do not appear related to the operator. Current strategy appears effective and the further attempts to control pain for this procedure may not be indicated.Serious adverse events following BMAB though rare, but nevertheless can have considerable impact on individual patients.There is a potential for dangerous adverse events following BMAB.
Session topic: 36. Quality of life, palliative care, ethics and health economics
Keyword(s): Bone marrow biopsy, Complications, Pain