Ultrasound-guided Fine-needle Aspiration Biopsy of Thyroid Nodules: Comparison of the Pain Scale according to the Application of Local Anesthesia

ABSTRACT

PURPOSE: This study was designed to evaluate the difference in the degree of patient pain during an ultrasoundguided fine-needle aspiration biopsy (US-FNAB) with the use of a one-needle puncture for thyroid nodules with the application of local anesthesia. MATERIALS AND METHODS: We prospectively examined patients who simultaneously received US-FNAB for two thyroid nodules, for one nodule in the right lobe and one nodule in the left lobe, where the nodules were larger than 10 mm in the maximum diameter. US-FNAB with or without local anesthesia was performed with the use of a 23-guage needle in all patients. The degree of pain after performing US-FNAB was evaluated by the use of an 11-point numeric rating scale. RESULTS: For all 20 patients, US-FNAB was performed with an alternative selection of the nodules. There were 14 patients with a higher pain score where local anesthesia was administered, two patients with a higher pain score where local anesthesia was not administered and four patients with the same score where both methods were used. There was a statistically significant difference in the pain score between the use of the two methods (Wilcoxon sign rank test, p = 0.014). The mean value of the pain score was 3.1 in patients who received local anesthesia and 2.1 in patients that did not receive local anesthesia, respectively. CONCLUSION: The use of local anesthesia is not superior to the use of no anesthesia regarding pain relief if USFNAB is performed with a one-needle puncture.