Digestive Diseases and Sciences

, Volume 47, Issue 10, pp 2151–2153 | Cite as

Predictors of Pain Medication Use After Percutaneous Liver Biopsy

  • Thomas R. RileyIII


The aim of this study is to identify risk factors for analgesic use following liver biopsy. In all, 121 consecutive biopsies were examined prospectively. Five variables were selected that might predict analgesia use: (1) anxiety, (2) request for sedation, (3) chronic use of addictive medications, (4) previous intravenous drug use, and (5) analgesia requirement with previous biopsies. Analgesia and narcotic requirement after liver biopsy were 35% and 15%, respectively. There was a lower average age (43 vs 47) (P = 0.03) and a higher Knodell score (7.2 vs 5.8) (P = 0.04) in those that required analgesics. The diagnosis of HCV (P = 0.007), previous intravenous drug abuse (IVDA) (P = 0.0001), request for medications before biopsy (P = 0.02), anxiety expressed (P = 0.0002), and chronic use of addictive medications (P = 0.03) predicted analgesia use. Previous IVDA (OR 9.3) and anxiety (OR 3.9) are predictive of pain medication use. In conclusion, patient characteristics play an important role in pain medication requirement after liver biopsy. If pain after liver biopsy is to be reduced, one has to understand the predisposing factors. Further studies utilizing behavior modification are warranted.

analgesics narcotics addiction hepatitis C needle biopsy 


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  1. 1.
    Babb RR, Jackman RJ: Needle biopsy of the liver: A critique of four currently available methods. West J Med 150:39–42, 1989Google Scholar
  2. 2.
    Van Leeuwan DJ, Wilson L, Crowe DR: Liver biopsy in the mid-1990: Questions and answers. Semin Liver Dis 15:340–359, 1995Google Scholar
  3. 3.
    Janes CH, Lindor KD: Outcome of patients hospitalized for complications after outpatient liver biopsy. Ann Intern Med 118:96–98, 1993Google Scholar
  4. 4.
    McGill DB, Rakela J, Zinsmeister AR, Ott BJ: A 21-year experience with major hemorrhage after percutaneous liver biopsy. Gastroenterology 99:1396–1400, 1990Google Scholar
  5. 5.
    Mahal AS, Knauer CM, Gregory PB: Bleeding after liver biopsy. West J Med 134:11–14, 1981Google Scholar
  6. 6.
    Perrault J, McGill DB, Ott BJ, Taylor WF: Liver biopsy: complications in 1000 inpatients and outpatients. Gastroenterology 74:103–106, 1978Google Scholar
  7. 7.
    Castera L, Negre I, Samii K, Buffet C: Pain experienced during percutaneous liver biopsy. Hepatology 30:1529–1530, 1999Google Scholar
  8. 8.
    Pasha T, Gabriel S, Therneau T, Dickson R, Lindor KD: Cost-effectiveness of ultrasound-guided liver biopsy. Hepatology 27:1220–1226, 1998Google Scholar
  9. 9.
    Lindor KD, Bru C, Jorgensen RA, Rakela J, Bordas JM, Gross JB, Rodes J, Mcgill DB, Reading CC, James EM, Charboneau JW, Ludwig J, Batts KP, Zinsmeister AR: The role of ultrasonography and automatic-needle biopsy in outpatient percutaneous liver biopsy. Hepatology 23:1079–1083, 1996Google Scholar
  10. 10.
    Riley TR: How often does ultrasound marking change the liver biopsy site? Am J Gastroenterol 94:3320–3322, 1999Google Scholar
  11. 11.
    Smith CI, Reddy R: Cost-effectiveness of ultrasonography in percutaneous liver biopsy. Hepatology 29:610, 1999 (letter)Google Scholar
  12. 12.
    Alexander JA, Smith BJ: Midazolam sedation for percutaneous liver biopsy. Dig Dis Sci 38:2209–2211, 1993Google Scholar

Copyright information

© Plenum Publishing Corporation 2002

Authors and Affiliations

  • Thomas R. RileyIII
    • 1
  1. 1.Department of Medicine, Division of Gastroenterology and Hepatology, The Hershey Medical CenterPennsylvania State University College of MedicineHersheyUSA

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