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A prospective randomised study of a rotary powered device (OnControl) for bone marrow aspiration and biopsy.

Abstract：

INTRODUCTION:Bone marrow aspiration and biopsy is an invasive procedure associated with morbidity and mortality risk. We compared a powered bone marrow aspiration and biopsy device to the traditional method by relatively assessing pain scores, procedure times, biopsy capture rates, quality of material retrieved, and safety and operator satisfaction. METHODS:Two large academic medical centres participated in this trial. Patients were randomised to have procedures carried out using the powered system or the manual technique. A visual analogue scale pain score was recorded immediately following skin puncture and once again at the end of the procedure for each patient. Procedure time was measured from skin puncture to core specimen acquisition. Pathologic assessment of 30 randomised samples was carried out. Operator satisfaction with devices was measured on a scale of 0-10, with 10 as the highest rating. RESULTS:Five operators from two sites enrolled 50 patients (powered, n=25; manual, n=25). Groups were evenly matched, with no significant differences in the means for age, weight and height. The powered system was superior to the manual system with respect to patient perceived pain from needle insertion (2.6±2.0 vs 4.1±2.5, p=0.022) and procedural time (100.0±72.8 s vs 224.1±79.0 s, p<0.001). Overall pain scores at the end of both procedures were comparable (3.2±2.2 vs 3.8±3.0, p=0.438). No complications were observed in either arm of the study. Blinded pathologic analysis of the specimens retrieved revealed that cores obtained using the powered system were longer and wider than those obtained using the manual technique (25.4±12.3 mm² vs 11.9±5.6 mm², p=0.001). For marrow aspiration, no difference was seen between groups for clot/particle spicules or smear spicules. Operator assessment favoured the use of the powered device. CONCLUSIONS:Results of this trial suggest that the use of a powered bone marrow biopsy device significantly reduces needle insertion pain and procedural time when compared to a manual technique. The superior size and overall quality of core specimens retrieved by the powered device provides more material for pathologic evaluation, thereby increasing diagnostic yield and reducing the need for repeat procedures.

journal_name

J Clin Pathol

journal_title

Journal of clinical pathology

authors

Swords RT,Anguita J,Higgins RA,Yunes AC,Naski M,Padmanabhan S,Kelly KR,Mahalingam D,Philbeck T,Miller L,Puga TA,Giles FJ,Kinney MC,Brenner AJ

doi

10.1136/jclinpath-2011-200047

subject

Has Abstract

pub_date

2011-09-01 00:00:00

pages

809-13

issue

eissn

0021-9746

issn

1472-4146

pii

jclinpath-2011-200047

journal_volume

pub_type

杂志文章,多中心研究,随机对照试验

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A prospective randomised study of a rotary powered device (OnControl) for bone marrow aspiration and biopsy.