So this is, I think this is a topic that comes up a lot when patients are told they need a bone marrow biopsy. Sedation can be a useful tool to help a patient tolerate a bone marrow biopsy better. At our center at Huntsman Cancer Hospital, we do so many outpatient biopsies that our outpatient provider, APCs, PAs and MPs are so skilled and efficient that generally introducing sedation actually just prolongs the process and makes the process more burdensome and uncomfortable for the patient. So I would say on the whole, our patients prefer to do this without sedation. Some centers use sedation for every biopsy. So if you come to us from an outside facility, it may be that you're only used to having these with sedation. At our facility, if you have a biopsy with sedation, you would do that in interventional radiology and they would give you a combination of IV medications that helps take away pain and helps you not be aware of the procedure going on and not remember that it occurred. This is similar to like what you get for a colonoscopy. It's called conscious sedation. You're not completely anesthetized, so you don't have to have, you don't have to be on a respirator or ventilator while you're sedated. The role of sedation is for patients who have a hard time tolerating the in-clinic procedure with just lidocaine and sometimes that occurs and we're totally open to discussing that with patients. The benefit of doing a biopsy without sedation in my opinion is that if you don't sedate someone, you can't over sedate them. So a bone marrow biopsy is generally a very low risk procedure. There's a few major risks and those include bleeding, hematoma formation, and infection. Those risks are easily mitigated and rarely occur if ever at all. But if you add sedation to the mix, it's possible that you could give someone a little too much sedation medication. You could over sedate them and they need a ventilator for a few minutes. You could sedate them so much that they have to spend two or more hours in the recovery room and it prolongs their day in the hospital. You can have after effects of those sedation medications for several days afterwards. So you just introduce a whole host of other side effects when sedating a patient for an otherwise low risk procedure. So usually we encourage our patients to try a biopsy without sedation and then check in with them about how it went and we can adjust in the future if necessary. So if you don't take any medications before, oral medications prescribed by your treating team and you don't get sedation, you don't need someone to drive you home. You can drive home. Because the only medication we use for pain control in a non-sedation biopsy is lidocaine which doesn't have any central effect. So you'll be alert and awake and usually people just experience some mild soreness which is totally possible to drive afterwards. If you are sedated, yes, you absolutely have to have a caregiver come with you and drive you home otherwise they won't sedate you. So if you show up without a caregiver, you usually have to reschedule your procedure if you're planning for sedation. The in-between here is maybe you're prescribed a drug, a class of drugs called benzodiazepines or other pain medications that may need about four hours to wear off before it's safe to drive. In that case, if you show up without a caregiver, you may just be asked to wait in the hospital for four hours until you can drive yourself home or you could come with a caregiver.
HealthTree • August 22, 2023