Use of Buffered Lidocaine in Bone Marrow Biopsies: A RCT
Use of Buffered Lidocaine in Bone Marrow Biopsies: A RCT
Purpose/Objectives: To determine whether a difference exists in perceived pain during preprocedure anesthetic injection for bone marrow biopsybetween buffered and unbuffered lidocaine,to determine whether pain levels change over time, and to investigaterelationships between perceived pain scores and other variables.
Design: A double-blind, randomized, experimental, crossover design.
Setting: A large hospital in the midwestern region ofthe United States.
Sample: 48 patients undergoing bone marrow biopsy.
Methods: The patients served as their own controls for the bilateral procedure. A100 mm visual analog scale measured pain. A demographic questionnaire gatheredthe between-subjects exploratory variables.
Main Research Variables: Perceived pain scores and type of lidocaine anesthetic solution (buffered versus unbuffered).
Findings: Participants reported significantly lower pain scores on the sideanesthetized with buffered lidocaine compared withthe side anesthetized with unbuffered lidocaine. Higher pain scores werereported on the treatment side for participants who had received more than twosurgical procedures. Patients who were members of a minority group had highermean pain scores than Caucasians on the control side.
Conclusions: Buffered lidocaine is superior to unbuffered lidocaine as ananesthetic for bone marrow biopsy procedures.
Implications for Nursing: Advanced practice nurses perform a significantnumber of bone marrow biopsies and aim to improve patient comfort duringinvasive procedures. Use of unbuffered lidocaine should be questioned.
Patients with cancer require numerous invasive procedures throughout their disease process, including bone marrow biopsies, lumbar punctures, and aspiration of fluid from organ cavities. The procedures generally cause discomfort. One of the biggest concerns for healthcare providers is keeping patients comfortable. Lessening the pain that patients experience during invasive procedures is one way to improve patient comfort.
Abstract
Purpose/Objectives: To determine whether a difference exists in perceived pain during preprocedure anesthetic injection for bone marrow biopsybetween buffered and unbuffered lidocaine,to determine whether pain levels change over time, and to investigaterelationships between perceived pain scores and other variables.
Design: A double-blind, randomized, experimental, crossover design.
Setting: A large hospital in the midwestern region ofthe United States.
Sample: 48 patients undergoing bone marrow biopsy.
Methods: The patients served as their own controls for the bilateral procedure. A100 mm visual analog scale measured pain. A demographic questionnaire gatheredthe between-subjects exploratory variables.
Main Research Variables: Perceived pain scores and type of lidocaine anesthetic solution (buffered versus unbuffered).
Findings: Participants reported significantly lower pain scores on the sideanesthetized with buffered lidocaine compared withthe side anesthetized with unbuffered lidocaine. Higher pain scores werereported on the treatment side for participants who had received more than twosurgical procedures. Patients who were members of a minority group had highermean pain scores than Caucasians on the control side.
Conclusions: Buffered lidocaine is superior to unbuffered lidocaine as ananesthetic for bone marrow biopsy procedures.
Implications for Nursing: Advanced practice nurses perform a significantnumber of bone marrow biopsies and aim to improve patient comfort duringinvasive procedures. Use of unbuffered lidocaine should be questioned.
Introduction
Patients with cancer require numerous invasive procedures throughout their disease process, including bone marrow biopsies, lumbar punctures, and aspiration of fluid from organ cavities. The procedures generally cause discomfort. One of the biggest concerns for healthcare providers is keeping patients comfortable. Lessening the pain that patients experience during invasive procedures is one way to improve patient comfort.
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