Assessment of Pain Caused by Invasive Procedures in Cancer Patients

Authors:
Jana Portnow From City of Hope National Medical Center, Duarte, California and The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland.

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Christine Lim From City of Hope National Medical Center, Duarte, California and The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland.

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, and
Stuart A. Grossman From City of Hope National Medical Center, Duarte, California and The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland.

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Volume/Issue:
Volume 1: Issue 3
Online Publication Date:
Jul 2003
DOI:
https://doi.org/10.6004/jnccn.2003.0037
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Invasive procedures are commonly required in the diagnosis and management of cancer in adults. However, little is known regarding the prevalence and severity of procedure-related pain in this patient population. This prospective study was conducted to determine the frequency and types of invasive procedures performed in a large comprehensive cancer center, the intensity of pain associated with these procedures, the types of periprocedural analgesics administered, and how these patients would like their procedural pain to be managed in the future. During a 6-week period, 102 cancer patients were interviewed immediately after undergoing an invasive procedure. They were asked to rate the pain they experienced before, during, and after their procedure using a verbal descriptor scale (VDS) ranging from 0 to 10. They also were asked if they would want more, less, or the same amount of pain medication if they were to undergo the same procedure again. The most frequently performed procedures were bone marrow aspirates and biopsies (68%), lumbar punctures (14%), and placements of central venous catheters (10%). The average pain rating during these procedures was 4.2 (standard deviation [SD], 3.0). However, 26% of patients experienced severe pain (VDS score [threesuperoir]7) during the procedures. Twenty-four percent of patients surveyed received conscious sedation for their procedure. There was no statistical relationship between patients' pain ratings and their satisfaction with the pain control they received during the procedures. This study represents the largest descriptive study of procedural pain in adult cancer patients. As more than 50% of these patients experienced moderate to severe pain during procedures, further studies are needed to improve the control of procedure-related pain in patients with cancer.

Correspondence: Jana Portnow, Department of Medical Oncology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA 91010. E-mail: jportnow@coh.org
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Print ISSN:
1540-1405
Online ISSN:
1540-1413
Publisher:
National Comprehensive Cancer Network
Cover Journal of the National Comprehensive Cancer Network
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Copyright:
Copyright © 2003 by the National Comprehensive Cancer Network 2003
Page Numbers:
5
Article Category:
Research Article
Received:
25 Feb 2003
Accepted:
10 Apr 2003
Print Publication Date:
01 Jul 2003
Online Publication Date:
Jul 2003
Keywords:
Procedures; pain; cancer; pain management

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