Euroasian Journal of Hepato-Gastroenterology

Register      Login

VOLUME 7 , ISSUE 2 ( July-December, 2017 ) > List of Articles

ORIGINAL ARTICLE

Effectiveness of Sedoanalgesia in Percutaneous Liver Biopsy Premedication

Orhan Sezgin, Serkan Yaras, Fehmi Ates, Engin Altintas, Bunyamin Saritas

Citation Information : Sezgin O, Yaras S, Ates F, Altintas E, Saritas B. Effectiveness of Sedoanalgesia in Percutaneous Liver Biopsy Premedication. Euroasian J Hepatogastroenterol 2017; 7 (2):146-149.

DOI: 10.5005/jp-journals-10018-1236

License: CC BY 3.0

Published Online: 01-12-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim

Percutaneous needle liver biopsy (PLB) is frequently associated with pain and anxiety. This may discourage the patients for biopsy, and rebiopsies, if needed. We planned a study to investigate the efficacy of additional analgesia or sedation for PLB.

Materials and methods

The study has been designed as a single-center, prospective study. The PLB was planned for 18- to 65-year-old consecutive patients who were included in the study. The patients were divided into three premedication groups as control, Meperidine, and Midazolam. Hospital Anxiety and Depression Scale (HADS) was used to measure each subject's anxiety level. Fifteen minutes before the biopsy, 1 mL 0.9% NaCl subcutaneously (sc), 1 mg/kg (max 100 mg) Meperidine sc, or 0.1 mg/kg (max 5 mg) Midazolam intravenously was administered to patients respectively. Then PLB was done with 16 G Menghini needle. The day after, the patients were asked about feelings regarding biopsy.

Results

Groups were similar by gender and age. The HADS scores prior to PLB and on visual analog scale (VAS, 1—10 points) score during PLB were similar. In the three groups, 7, 12, and 7 patients, respectively, experienced no pain. Other patients explained pain as mild or moderate or severe. The number of patients who agreed for possible rebiopsy was higher in Meperidine and Midazolam groups than in the control group.

Conclusion

Premedication with Meperidine or Midazolam in PLB would improve patients' tolerance, comfort, and attitude against a possible repeat PLB.

How to cite this article

Sezgin O, Yaras S, Ates F, Altintas E, Saritas B. Effectiveness of Sedoanalgesia in Percutaneous Liver Biopsy Premedication. Euroasian J Hepato-Gastroenterol 2017;7(2):146-149.


  1. Current trends in theory and research on anxiety. In: Spielberger CD, editor. Anxiety: current trends in theory and research. Vol. 1. New York: Academic Press; 1972. p. 3-19.
  2. Percutaneous biopsy in diffuse liver disease: increasing diagnostic yield and decreasing complication rate by routine ultrasound assessment of puncture site. Am J Gastroenterol 1996 Jul;91(7):1318-1321.
  3. Controlling pain in liver biopsy, or “we will probably need to repeat the biopsy in a year or two to assess the response”. Am J Gastroenterol 2001 May;96(5):1327-1329.
  4. Outcome of patients hospitalized for complications after outpatient liver biopsy. Ann Intern Med 1993 Jan;118(2):96-98.
  5. Liver biopsy: complications in 1000 inpatients and outpatients. Gastroenterology 1978 Jan;74(1):103-106.
  6. Guided versus blind liver biopsy for chronic hepatitis C: clinical benefits and cost. J Hepatol 1999 Apr;30(4):580-587.
  7. Safety assessment of high-dose narcotic analgesia for emergency department procedures. Ann Emerg Med 1993 Sep;22(9):1444-1449.
  8. Midazolam: a review of its use for conscious sedation of children. Pediatr Dent 1993 Jul-Aug;15(4):237-241.
  9. Chemical structure and properties of midazolam compared with other benzodiazepines. Br J Clin Pharmacol 1983;16(Suppl 1):11S-16S.
  10. Efficacy and safety of diazepam and meperidine combination for pediatric gastrointestinal procedures. J. Pediatr Gastroenterol Nutr 1990 Apr;10(3):335-338.
  11. Use of midazolam for percutaneous liver biopsy. Dig Dis Sci 1989 Oct;34(10):1553-1558.
  12. Liver biopsies in patients with lysosomal storage disease: experience with effective sedation. Indian J Pediatr 1997 Nov-Dec;64(6):887-891.
  13. Prevalence and characteristics of pain induced by percutaneous liver biopsy. Anesth Analg 2003 May;96(5):1392-1396.
  14. Needle biopsy of the liver. In: Sherlock S, Dooley J, editors. Diseases of the liver and biliary system. 9th ed. Oxford: Blackwell Scientific; 1993. p. 33-43.
  15. Needle biopsy of the liver. In: Schiff L, Schiff ER, editors. Diseases of the liver. 7th ed. Philadelphia: JB Lippincott; 1993. p. 216-225.
  16. Practices of liver biopsy in France: results of a prospective nationwide survey. For the Group of Epidemiology of the French Association for the Study of the Liver (AFEF). Hepatology 2000 Sep;32(3):477-481.
  17. Liver biopsy. Hepatology 2009 Mar;49(3):1017-1044.
  18. Guidelines on the use of liver biopsy in clinical practice. Br Soc Gastroenterol Gut 1999 Oct;45 (Suppl 4):IV1-IV11.
  19. Percutaneous liver biopsies: safety and efficacy. Turkiye Klinikleri J Med Sci 2010;30(4)1287-1291.
  20. Antidepressant treatment and cultural differences—a survey of the attitudes of physicians and patients in Sweden and Turkey. BMC Fam Pract 2010 Nov;11:93.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.