• Tracy A Ruegg, Christine R Curran, and Tammy Lamb.
• Ohio State University's Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio, USA. tracy.ruegg@osumc.edu
• Oncol Nurs Forum. 2009 Jan 1; 36 (1): 52-60.

Purpose/ObjectivesTo determine whether a difference exists in perceived pain during preprocedure anesthetic injection for bone marrow biopsy between buffered and unbuffered lidocaine, to determine whether pain levels change over time, and to investigate relationships between perceived pain scores and other variables.DesignA double-blind, randomized, experimental, crossover design.SettingA large hospital in the midwestern region of the United States.Sample48 patients undergoing bone marrow biopsy.MethodsThe patients served as their own controls for the bilateral procedure. A 100 mm visual analog scale measured pain. A demographic questionnaire gathered the between-subjects exploratory variables.Main Research VariablesPerceived pain scores and type of lidocaine anesthetic solution (buffered versus unbuffered).FindingsParticipants reported significantly lower pain scores on the side anesthetized with buffered lidocaine compared with the side anesthetized with unbuffered lidocaine. Higher pain scores were reported on the treatment side for participants who had received more than two surgical procedures. Patients who were members of a minority group had higher mean pain scores than Caucasians on the control side.ConclusionsBuffered lidocaine is superior to unbuffered lidocaine as an anesthetic for bone marrow biopsy procedures.Implications For NursingAdvanced practice nurses perform a significant number of bone marrow biopsies and aim to improve patient comfort during invasive procedures. Use of unbuffered lidocaine should be questioned.

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