Reducing pain and discomfort during and after bone marrow aspiration

A bone marrow aspiration and biopsy (BMAB) is a diagnostic medical intervention which is

generally conducted with only local anaesthesia. Most of the patients experience discomfort

and pain during this procedure and do not favour a next BMAB. No strict guideline exists on

the use of pain and anxiety medication before a BMAB. In our hospital setting two different

premedication schemes are used for pain and anxiety reduction. This study will investigate

the different schemes of premedication on the pain during and after a BMAB and for the fear

for a possible next BMAB. The main objective is to investigate which premedication scheme

reduces best the pain during and after a BMAB and which premedication scheme reduces

best the fear for a possible next BMAB. We will conduct a double-blind randomized

controlled study and adult patients with an indication to undergo a first bone marrow

aspiration and/or biopsy will be included. The two different premedication schemes consist of

1: lorazepam 1mg and paracetamol 1000mg both oral administration and 2: midazolam

7,5mg and morphine 10mg both oral administration. The primary study endpoints are the

Visual Analogue Scale (VAS) for pain, scored directly after the procedure and fear for a next

BMAB scored on a VAS for anxiety two weeks after the procedure. Secondary endpoints are

discomfort and patient related factors for pain experience.

The main objective of this study is to investigate which premedication scheme reduces best the pain during and after a bone marrow aspiration and biopsy and reduces best the fear for a possible next bone marrow aspiration and biopsy.

VAS for pain directly after procedure, VAS for anxiety, fear for a next bone marrow biopsy, 2 weeks after the procedure

Group 1: midazolam 7,5mg, oral, single dose AND morphine 10mg, oral single dose

Group 2: lorazepam 1mg, oral single dose AND paracetamol 1000mg, oral, single dose