Postinterventional pain and complications of sonographically guided interventions in the liver and pancreas

• Published in: Ultraschall in der Medizin Vol. 35; no. 2; p. 159
• Main Authors: Lindner, A, Frieser, M, Heide, R, Wildner, D, Neurath, M F, Dauth, W, Bernatik, T, Strobel, D
• Format: Journal Article
• Language: English
• Published: Germany 01.04.2014
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Analgesics - therapeutic use; Biopsy, Needle - adverse effects; Female; Humans; Liver - diagnostic imaging; Liver - pathology; Liver Abscess - pathology; Liver Abscess - surgery; Liver Neoplasms - pathology; Male; Middle Aged; Pain Measurement; Pain, Postoperative - drug therapy; Pain, Postoperative - etiology; Pancreas - diagnostic imaging; Pancreas - pathology; Postoperative Complications - drug therapy; Postoperative Complications - etiology; Prospective Studies; Sex Factors; Surveys and Questionnaires; Ultrasonography, Interventional - adverse effects; Young Adult
• ISSN: 1438-8782
• DOI: 10.1055/s-0032-1330497

Sonographically guided interventions in abdominal organs are routine procedures with rare severe complications. However, potential patient discomfort or pain is frequently not addressed in the literature. In a prospective 1-year study, the peri- and postinterventional pain of patients undergoing sonographically guided punctures of the liver and pancreas was analyzed. Data acquisition was done with a standardized questionnaire. This included three numeric rating scales (NRS) ranging from "0" to "10" to be answered at puncture and 1 hour and 4 hours later. Data concerning complications and administered analgesic medication was acquired from the patients' charts. 223/274 patients could be analyzed (83 %). 91 women (40.8 %) and 132 men (59.2 %) were included. The mean age was 56.0 yrs. Overall the average level of pain was 2.98  at puncture, 1.21 after 1 hour and 0.71 after 4 hours. In patients with diagnostic biopsies, the pain levels were 3.37(0  h)/1.33(1  h)/0.71(4  h) for liver parenchyma, 2.64(0  h)/0.95(1  h)/0.65(4  h) for focal liver lesions and 3.1(0  h)/1.9(1  h)/1.1(4  h) for pancreatic punctures. The pain levels at therapeutic interventions were 3.00(0  h)/2.00(1  h)/0.50(4  h). Female and younger (< 50 yrs) patients had statistically significantly more pain at puncture and 1 hour postintervention. Only minor complications occurred (0.9 %). Severe pain after sonographically guided interventions is rare. Most patients suffer only from mild pain postinterventionally.