Pain During Percutaneous Liver Biopsy in Chronic Liver Disease Patients a Pilot Study

Abstract

Purpose:  To compare pain levels as measured by visual analog scale (VAS) between pain experienced during local anesthesia and pain during Percutaneous Liver Biopsy (PLB).

Study Design:  This is an observational study. Place and Duration of Study:  This study was conducted for one year i;e July 2007-July 2008 at Combined Military Hospital, Sialkot.

Materials and Methods:  Adult patients suffering from chronic liver disease were selected for liver biopsy. They were explained the biopsy procedure and also how to mark the visual analogue scale from 0 to 100. On that scale, the left end point, 0, was defined as no pain and the right end point, 100, as the worst pain the patient could imagine. There were no further marks on the line. Prothrombin time, platelet count, and a complete blood count were obtained prior to the biopsy. Biopsy was done under local anesthesia. Patient was asked to mark the visual analogue scale both for pain during local injection and for biopsy on two separate lines just after the procedure.

Results:  Out of 51 patients, 27 (52.9%) were female and 24 (47.1%) male. Mean age was 36.3 ± 8.1 years. Thirty three (64.70%) has less than 23 mm pain on VAS scale during local anesthesia compared to pain felt during biopsy which was less than 19 males on VAS among 64.70% cases. In the rest of patient biopsy was pain free (P = 0.05). Pain has no correlation with age (P < 0.12) and needle size (P < 0.15).

Conclusion:  In conclusion, the results of this pilot study suggest that, although deemed as minor, pain experienced during Percutaneous liver biopsy should be taken into consideration and that patients should be provided adequate prophylactic analgesia.

Key Words:  Visual Analog Scale (VAS), Percutaneous Liver Biopsy (PLB).