Comparing Pain in Patients Undergoing Percutaneous Versus Transjugular Techniques of Liver Biopsy

Millions of Americans are diagnosed with some form of Hepatitis or other liver disease requiring treatment. Liver biopsies are frequently performed mainly to stage disease, aid in diagnosis and to guide treatment. As part of the assessment of Hepatitis patients, a liver biopsy is frequently part of the regimen. Liver biopsy procedures can be performed using one of two methods: percutaneous liver biopsy (PLB) or transjugular liver biopsy (TLB). Alknawy \& Shiffman (2007) discuss approaches of percutaneous liver biopsy that included the percussion-palpation approach, image guided, ultrasound assisted, ultrasound guided and type of biopsy needle used. The method of liver biopsy selected will not be randomly assigned but will be determined by the hepatologist caring for the patient. Pain can be a complication following a liver biopsy requiring adequate pain management. Despite an extensive review of previous studies, none were found that discussed the pain experiences of patients who have undergone PLB versus TLB. This study proposes to compare the amount of pain experienced by patients who have undergone PLB versus TLB. Thirty-two male and female patients age 18 years and older who meet study criteria will be invited to participate. The participants will be placed into either the PLB or TLB group with each group consisting of 16 male or 16 female participants. Prior to the biopsy and within the first 6 hours post procedure, at the 2, 4 and 6-hour time points, the patient will be asked to rate their pain on the Visual Analogue Scale (VAS) and on the Numeric Pain Scale (NPS). Additionally, the dolorimeter will be used pre liver biopsy along with the VAS and the NPS as standardized pain measurements.