Management for bone marrow aspirations and biopsies includes the use, along with local anesthesia, of either general anesthesia or conscious sedation with benzodiazepines and opioids. Adequate time is necessary for the local anesthetic agent to have full effect.
In children, nonpharmacologic methods with demonstrated efficacy for lumbar punctures and bone marrow aspirations and biopsies include hypnosis (Zeltzer and LeBaron, 1982); thought stopping (Ross, 1984); and a multidimensional psychological intervention that includes a breathing exercise, reinforcement, imagery, behavioral rehearsal, and filmed modeling (Jay, Elliott, Ozolins, et al., 1985). These strategies alone, however, often do not reduce pain sufficiently.
In addressing procedure-related pain, clinicians should consider the nature of the procedure (invasive or noninvasive), the degree of pain expected, and the needs of the patient in the development of a plan that emphasizes prevention of pain before the procedure. Further, especially in children, followup should include an assessment of pain secondary to the inflammatory process and provision of treatment (e.g., applications of cold or heat unless contraindicated or use of mild analgesics or NSAID).
Adjuvant analgesic drugs for cancer pain
Catheter Placement for Drug Delivery
PROCEDURE-RELATED PAIN IN ADULTS AND CHILDREN
Managing Procedure-Related Pain
Pharmacologic agents for management of procedural pain
PAIN IN SPECIAL POPULATIONS
Pain in Neonates, Children, and Adolescents
Medical Interventions
Index