Ultrasound-Guided Fine-Needle Aspiration Biopsy of Thyroid Nodules: is it Necessary to Use Local Anesthesia for the Application of One Needle Puncture?.
10.3348/kjr.2009.10.5.441
- Author:
Dong Wook KIM
1
;
Myung Ho RHO
;
Ki Nam KIM
Author Information
1. Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Pusan 614-735, Korea.
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Thyroid nodule;
Fine-needle biopsy;
Pain;
Local anesthesia;
Ultrasound (US)
- MeSH:
Adult;
Aged;
Anesthesia, Local/*utilization;
Biopsy, Fine-Needle/*adverse effects;
Female;
Humans;
Male;
Middle Aged;
Pain Measurement;
Prospective Studies;
Punctures/adverse effects;
Statistics, Nonparametric;
Thyroid Neoplasms/*pathology/ultrasonography;
Thyroid Nodule/*pathology/ultrasonography;
*Ultrasonography, Interventional
- From:Korean Journal of Radiology
2009;10(5):441-446
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: This study was designed to evaluate the difference in the degree of patient pain for an ultrasound-guided fine-needle aspiration biopsy (USFNAB) of a thyroid nodule with one needle puncture with and without local anesthesia. MATERIALS AND METHODS: A total of 50 patients participated in the study. We examined prospective patients who would undergo US-FNABs of two thyroid nodules (larger than 10 mm maximum diameter), which were located in separate thyroid lobes. For one of these thyroid nodules, US-FNAB was performed following the administration of local anesthesia; for the other nodule, no anesthesia was administered. The application of anesthesia was alternatively administered between patients (either prior to the first US-FNAB procedure or prior to the second procedure). For all patients, the degree of pain during and after each US-guided FNAB was evaluated according to a 4-category verbal rating scale (VRS), an 11-point numeric rating scale (NRS) and a 100-mm visual analogue scale (VAS). RESULTS: The mean maximum diameters of thyroid nodules examined by US-FNAB with the use of local anesthesia and with no local anesthesia were 13.6 mm and 13.0 mm, respectively. There was no significant difference in nodule size (p > 0.05) between two groups. For the VRS, there were 27 patients with a higher pain score when local anesthesia was used and four patients with a higher pain score when no local anesthesia was administered. Nineteen patients had equivalent pain score for both treatments. This finding was statistically significant (p < 0.001). For the NRS, there were 33 patients with a higher pain score when local anesthesia was used and 10 patients with a higher pain score when no local anesthesia was administered. Seven patients had an equivalent pain score for each treatment. This finding was statistically significant (p < 0.001). For the VAS, there were 35 patients with a higher pain score when local anesthesia was used and 11 patients with a higher pain score where no local anesthesia was administered. Four patients had an equivalent pain score for both treatments. This finding was also statistically significant (p = 0.001). CONCLUSION: In our study, patient pain scales were significantly lower when no local anesthesia was used prior to US-FNABs of thyroid nodules as compared to when local anesthesia was administered. Therefore, we believe that when one needle puncture is used, US-FNAB should be performed without administering local anesthesia.
