A comparison of pain intensity and anxiety during bone marrow biopsy under general anesthesia or local anesthesia in children with acute leukemia

Aim and scope: In recent years, the need to decrease pain and anxiety in patients with acute leukemia during invasive diagnostic and therapeutic measures has been emphasized. This study was performed with the aim of evaluating pain and discomfort caused by bone marrow aspiration under general anesthesia compared with local anesthesia. This cohort study was performed on 239 patients with acute leukemia under 18 years of age admitted to Dr. Sheikh Hospital in Mashhad during two years.Children undergoing bone marrow aspiration with either general anesthesia with propofol or local anesthesia with lidocaine were compared in terms of pain intensity (Visual Analogue Scale), resistance to procedure, and the fear and anxiety during aspiration. Results were evaluated with SPSS software version 16 using t test and chi-squared test. Among the 135 patients who were under general anesthesia, 20.1% showed a slight resistance to apply the anesthesia mask. The least amounts of pain, fear, and anxiety were reported. Among the 104 patients under local anesthesia, 80.2% had physical resistance, 44.4% had severe and very severe pain, and 86.1% showed intense fear and anxiety. In the general anesthesia group, physical resistance (p=0.01), pain (p=0.01), and fear and anxiety (p<0.005) were significantly lower than in the local anesthesia group. In bone marrow aspiration, general anesthesia is more acceptable to children and their parents than local anesthesia. This method can greatly reduce pain, resistance, and fear caused by the aggressive actions during bone marrow aspiration in children. (Quarterly Journal of Sabzevar University of Medical Sciences, Volume 19, Number 2, pp.173-180).