Management of Pain and Anxiety during Bone Marrow Aspiration: An Italian National Survey

Sarah J. Liptrott, Stefano Botti, Francesca Bonifazi, Marco Cioce, Valentina De Cecco, Anna Rita Pesce, Alessandro Caime, Elena Rostagno, Emanuela Samarani, Letizia Galgano, Fabio Ciceri, Laura Orlando, Gianpaolo Gargiulo

Research output: Contribution to journalArticlepeer-review


Background: Bone marrow aspiration (BMA) or biopsy is a necessary and frequent procedure for diagnosis and monitoring of hematological diseases. Pharmacological pain management approaches exist; however, previous experience and psychological preparation for BMA may impact pain perception. Aims: This study aimed to explore current practices in procedural pain management for BMA or biopsy. Design/Setting/Participants: A cross-sectional internet-based survey was performed by the Nurses Group of the Italian Transplant Group (GITMO). Participants were nurses working in bone marrow transplant centers regularly performing BMA/biopsies. Results: Sixty out of 94 centers receiving the survey responded (63.8%), 47 adult and 13 pediatric centers. The majority of them (75%) provided only verbal information for patient preparation before BMA. Injected local anesthetics were used in 55.4% of centers, and combined with topical anesthetics in 33.9% of centers. Use of oral anesthetics was rare; however, anxiolytics and benzodiazepines were occasionally used (18.3%, 18.3% respectively). All pediatric centers used deep sedation for the procedure (p < .001), but drug choice depended on anesthetist preference. Ice packs (35.0%) and oral analgesia as required (40.0%) were used for postprocedural pain. Nurses perceived their patients’ pain scores as relatively low (3.5 on scale 0–10), but recognized that it was a painful procedure provoking anxiety, and that pain management could be improved. Conclusions: Results revealed the lack of a standardized approach to procedural pain management for BMA in this study sample. Assessing a patient's pain experience is a key component to identifying effective pain management for BMA.

Original languageEnglish
Pages (from-to)349-355
Number of pages7
JournalPain Management Nursing
Issue number3
Publication statusPublished - Jun 2021

ASJC Scopus subject areas

  • Advanced and Specialised Nursing


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