Prospective randomized trial of post-liver biopsy recovery positions - Does positioning really matter?

Goals: The goal of this study was to compare three commonly practiced post-liver biopsy recovery postures with respect to pain levels and overall patient acceptability. Background: Percutaneous liver biopsy is a valuable procedure used in the diagnosis, prognosis, and treatment of liver diseases. No standardized recovery posture exists, and no studies have been performed to compare these different recovery techniques. Study: Ninety adult patients were randomized into three arms of the study: right-side (R), supine (S), and combination (C) groups. A validated Visual Analogue Scale (VAS) was given to patients to grade the pain and discomfort experienced during recovery intervals as well as to grade the overall acceptability of the biopsy experience. Results: Immediately following liver biopsy, more pain was experienced by patients randomized to R with a mean VAS score of 26.5 of 100, compared with 14.2 (P = 0.026) and 12.1 (P = 0.009) for C and S groups, respectively. At the end of recovery, there was no difference among the three groups. The mean acceptability score was 89.2 of 100 for C versus 94.5 for S (P = 0.047) and 94.8 for R (P = 0.046). Conclusion: This study is the first to examine differing post-liver biopsy techniques. When three commonly practiced recovery positions, C, R, and S, are compared, C was the least acceptable position. Patients should be placed in position R or S during recovery.