Ethnicity influences pain after ultrasound-guided percutaneous liver biopsy

Eur J Gastroenterol Hepatol. 2015 Dec;27(12):1378-81. doi: 10.1097/MEG.0000000000000465.

Abstract

Background: The influence of ethnicity on pain complicating ultrasound-guided percutaneous liver biopsy (US-guided PLB) and its clinical impact has not been reported to date.

Methods: Consecutive adults from a multiethnic background, undergoing an US-guided PLB, were independently assessed for pain up to 6 h after the procedure. Clinical and demographic parameters were analysed to determine independent predictors of significant pain after PLB. Willingness to undergo a repeat procedure was assessed 1 week after PLB.

Results: Data from 203 patients (median age 50 years; 43.9% female; ethnicity: Malay 41.5%, Chinese 40%, Indian 18%; median BMI 27.7 kg/m; median waist circumference 92.0 cm) were analysed. Pain after US-guided PLB was experienced in 133 (61.1%) patients, with severity grades as follows: none, n=81 (39.9%); mild, n=56 (27.6%); moderate, n=51 (25.1%); and severe, n=15 (7.4%). Analgesia requirements correlated well with severity of pain. Independent predictors of significant pain after PLB (moderate and severe categories) in patients included age less than 50 years [odds ratio (OR) 3.0], female sex (OR 3.7), Indian ethnicity (OR 2.9) and Malay ethnicity (OR 2.7), but not number of needle passes, BMI and educational levels. Patients who experienced moderate/severe pain were less willing to undergo a repeat PLB compared with those who experienced mild/no pain (60.9 vs. 82.8%, P=0.001).

Conclusion: Ethnicity has an important role in the development of pain after US-guided PLB. This has a significant impact on willingness to repeat the procedure.

MeSH terms

  • Adult
  • Anthropometry / methods
  • Asian People / statistics & numerical data
  • Biopsy, Needle / adverse effects*
  • Biopsy, Needle / methods
  • Female
  • Humans
  • Liver / diagnostic imaging
  • Liver / pathology*
  • Liver Diseases / diagnostic imaging
  • Liver Diseases / ethnology*
  • Liver Diseases / pathology
  • Malaysia / epidemiology
  • Male
  • Middle Aged
  • Pain / ethnology*
  • Pain / etiology
  • Pain Measurement / methods
  • Ultrasonography, Interventional / methods*