Zagouri Flora, Sergentanis Theodoros N, Gounaris Antonia, Koulocheri Dimitra, Nonni Afroditi, Domeyer Philip, Fotiadis Constantine, Bramis John, Zografos George C
Breast Unit, First Department of Propaedeutic Surgery, Hippokratio Hospital, University of Athens, Greece.
Breast. 2008 Feb;17(1):71-5. doi: 10.1016/j.breast.2007.07.039. Epub 2007 Sep 14.
This study examines pain (visual analog scale 0-10) in women undergoing breast biopsy. Two hundred and twenty-seven patients with a palpable lesion underwent FNA (21G, n=85), core biopsy (14G, n=86) or open biopsy under local anesthesia (n=56). One hundred and twenty-six women presented with a non-palpable lesion, and underwent vacuum-assisted breast biopsy (VABB, 11G) under mammographic guidance, prone position (n=72) or hook-wire localization followed by open surgery (n=54). The techniques sampling non-palpable lesions were the most painful: hook-wire (9.15+/-0.74) and VABB (4.35+/-1.70). Larger needle diameter was associated with more intense pain. Concerning VABB, an S-shape curve of pain (third-order pattern) was documented. A second dose of lidocaine just before the rapid increase phase was then adopted (n=61), and reduced the total/maximum pain. In conclusion, although VABB is less painful than hook-wire, the pain experienced in VABB is significant; however, it can be attenuated by a second dose of lidocaine.
本研究调查了接受乳房活检的女性的疼痛情况（视觉模拟评分0 - 10分）。227例可触及病变的患者在局部麻醉下接受了细针穿刺抽吸活检（FNA，21G，n = 85）、粗针活检（14G，n = 86）或开放活检（n = 56）。126例女性有不可触及的病变，在乳腺X线引导下、俯卧位接受了真空辅助乳房活检（VABB，11G，n = 72），或接受了钩丝定位后开放手术（n = 54）。对不可触及病变取样的技术最疼痛：钩丝活检（9.15±0.74）和真空辅助乳房活检（4.35±1.70）。更大的针径与更强烈的疼痛相关。关于真空辅助乳房活检，记录到疼痛呈S形曲线（三阶模式）。然后在快速上升期前采用第二剂利多卡因（n = 61），并减轻了总疼痛/最大疼痛。总之,虽然真空辅助乳房活检比钩丝活检疼痛轻，但真空辅助乳房活检时经历的疼痛仍很明显；然而，第二剂利多卡因可减轻疼痛。
