A randomized double-blind placebo-controlled study of low-dose intravenous lorazepam to reduce procedural pain during bone marrow aspiration and biopsy

Objective. To evaluate the efficacy of intravenous lorazepam as premedication for bone marrow aspiration and biopsy (BMAB). Design. Randomized, double-blind, placebo-controlled. Patients. One hundred and thirty-eight consenting patients planned to receive BMAB. Intervention. Patients were randomly assigned to receive either intravenous lorazepam 1 mg or placebo just prior to BMAB. Setting. Tertiary referral center, inpatient setting. Outcome Measures. A questionnaire was used to determine the patient perception about the procedure and pain at baseline, which was completed just after the procedure, and the next day after the BMAB. Pain was rated using a 10-cm linear visual analog scale (VAS). Results. The mean VAS scores measured during the BMAB examination were 6.0 for lorazepam vs 6.2 for placebo. Few adverse events were noted during intravenous lorazepam administration. The patients in the lorazepam group were more likely to accept the next BMAB (P = 0.044). Conclusion. Intravenous lorazepam was safe in patients undergoing BMAB and was more effective than placebo in enhancing cooperation during BMAB and willingness to undergo another procedure. However, use of lorazepam 1 mg provided no reduction in the pain associated with BMAB. Further studies should focus on providing appropriate analgesia for this potentially painful procedure.