Effects of fine-needle aspiration biopsy (FNAB) nodule depth on pain score

Toman, Hüseyin; Özkul, Faruk; Erbağ, Gökhan; Erbaş, Mesut; Şimşek, Tuncer; Adam, Gürhan; Arık, Muhammed Kasım; Aşık, Mehmet

doi:10.1007/s11845-015-1337-y

Cited by 11 publications

(8 citation statements)

References 18 publications

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“…Complications related to the procedure have been reported in some patients, including pain, hemorrhage, infection, recurrent laryngeal nerve injury, and needle track seeding. 4 Pain sensations for US-FNAB are related to the depth of the nodule, 15 number of nodules biopsied, 16 and use of LA, 7 , 17 but are not related to large needle size. 18 Some reports have suggested that US-FNAB should be performed without LA when one needle puncture is used.…”

Section: Discussionmentioning

confidence: 99%

Assessment of pain score and specimen adequacy for ultrasound-guided fine-needle aspiration biopsy of thyroid nodules

Liao

Hsu

et al. 2017

JPR

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ObjectiveThe aim of this study was to evaluate pain scores and specimen adequacy for ultrasound-guided fine-needle aspiration biopsy (US-FNAB) of thyroid nodules without and with local anesthesia (LA).Materials and methodsThe US-FNAB procedure was performed on 183 patients with and without LA. One puncture was made for solid nodules, and if patients could tolerate it, a two-puncture technique was used for nodules with a cystic change. Four-point verbal rating scores were assessed by a nursing assistant after completion of US-FNAB. To be an adequate specimen, at least six groups of follicular cells are required, and each group should contain at least 10 cells.ResultsImmediately after US-FNAB, 92% of patients with LA and 80% without LA reported no or mild pain (p=0.01). Most patients tolerated the procedure well, with no pain (82.5%) reported 5 minutes after the procedure. In univariate logistic regression, irregular boundary (odds ratio [OR]: 2.52, 95% confidence interval [CI]: 1.04–6.06, p=0.04), calcification (OR: 2.86, 95% CI: 1.06–7.76, p=0.04), and LA (OR: 0.35, 95% CI: 0.15–0.86, p=0.02) were significantly associated with immediate moderate or severe pain. Specimen adequacy was significantly associated with age (OR: 0.95, 95% CI: 0.92–0.97, p<0.01), heterogeneous echo-texture (OR: 1.76, 95% CI: 1.23–5.17, p=0.01), predominate solid architecture (OR: 2.78, 95% CI: 1.42–5.41, p<0.01), and the use of LA (OR: 3.34, 95% CI: 1.70–6.56, p<0.01). In multivariate logistic regression, patients receiving LA had lower risk of moderate or severe pain (OR: 0.25, 95% CI: 0.09–0.67, p=0.01) and higher chances of specimen adequacy (OR: 4.84, 95% CI: 2.17–10.7, p<0.01) compared to patients who did not receive LA.ConclusionUS-FNAB is a safe procedure, and most patients report no pain 5 minutes after the procedure. The use of LA was associated with lower immediate pain scales and higher specimen adequacy.

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Section: Discussionmentioning

confidence: 99%

Assessment of pain score and specimen adequacy for ultrasound-guided fine-needle aspiration biopsy of thyroid nodules

Liao

Hsu

et al. 2017

JPR

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“…The needle size, thyroid nodule size or depth, number of passes, physician's expertise, and technique used have not been demonstrated to contribute to increased discomfort during or after this procedure (20)(21)(22). A limited amount of research has found that age < 25 years old, female gender, anxiety, perpendicular technique, greater thyroid nodule depth and large needle gauge may associated with increased FNA related discomfort (8,(23)(24)(25)(26). The efficacy of anesthesia in reducing FNA related pain has yielded variable results with some studies finding it effective and others noting minimal to no benefit (7,23,(26)(27)(28).…”

Section: Discussionmentioning

confidence: 99%

Patient Discomfort in Relation to Thyroid Nodule Fine-Needle Aspiration (FNA) Performed with or without Parenteral and/or Topical Anesthetic

et al. 2020

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“…17 However, it should be noted that other studies have found no differences in pain perception between the genders during biopsy. 7,18 Age differences in pain perception are not well understood, 19 with some studies reporting an increase in experimental pain in older adults and others reporting the opposite findings. 20,21 However, several studies have reported no differences in pain scores and age.…”

Section: Discussionmentioning

confidence: 99%

“…25 We did not record the depth of the lesion in our audit data set, but it is known that there is an association between lesion depth in the thyroid and increased VAS score. 18 Thyroid biopsy was not included in this audit/service review as these procedures are performed by a different team.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasound-guided fine-needle aspiration cytology of lesions in the head and neck performed without local anaesthesia – An analysis of pain perception

2018

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Introduction: Ultrasound-guided fine-needle aspiration cytology is commonly carried out in the head and neck. The aim was to examine the amount of pain experienced by patients undergoing this procedure carried out without the use of local anaesthetic. Methods: A questionnaire was given to 109 consecutive patients undergoing ultrasound-guided fineneedle aspiration cytology containing a visual analogue scale. Patients were asked to mark with a vertical line on the 100 mm horizontal scale amount of pain they experienced during the biopsy. The pain was subsequently categorised as 'no pain', 'mild pain', 'moderate pain' or 'severe pain' based on previous pain studies. Results: Hundred patients completed the visual analogue scale section of the questionnaire satisfactorily. Twenty-one patients experienced no pain, 62 experienced mild pain and 17 experienced moderate pain. No patients experienced severe pain. Further analysis showed that females had significantly higher visual analogue scale scores (Mann-Whitney test: U ¼ 925.5, z ¼ 2.211, P ¼ 0.027). Patients who were aware that they were going to have a biopsy had significantly lower visual analogue scale scores than those who were not aware (Mann-Whitney test: U ¼ 859.5, z ¼ 2.263, P ¼ 0.024). Conclusions: Ultrasound-guided fine-needle aspiration cytology is generally a well-tolerated procedure with pain scores being higher in females. It is advised that patients are told by the referring clinician the need for biopsy as this reduces the amount of pain experienced.

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Effects of fine-needle aspiration biopsy (FNAB) nodule depth on pain score

Abstract: Our results show that pain increased significantly during FNAB in patients who had more deeply situated nodules. Local anesthetic methods may be recommended for these patients.

Cited by 11 publications

References 18 publications

Assessment of pain score and specimen adequacy for ultrasound-guided fine-needle aspiration biopsy of thyroid nodules

Assessment of pain score and specimen adequacy for ultrasound-guided fine-needle aspiration biopsy of thyroid nodules

Patient Discomfort in Relation to Thyroid Nodule Fine-Needle Aspiration (FNA) Performed with or without Parenteral and/or Topical Anesthetic

Ultrasound-guided fine-needle aspiration cytology of lesions in the head and neck performed without local anaesthesia – An analysis of pain perception

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