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

Ultraschall Med. 2014 Apr;35(2):159-65. doi: 10.1055/s-0032-1330497. Epub 2013 Jan 25.

Abstract

Purpose: 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.

Materials and methods: 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.

Results: 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 %).

Conclusion: Severe pain after sonographically guided interventions is rare. Most patients suffer only from mild pain postinterventionally.

MeSH terms

  • 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

Substances

  • Analgesics