Predictors of pain medication use after percutaneous liver biopsy

The aim of this study is to identify risk factors for analgesic use following liver biopsy. In all, 121 consecutive biopsies were examined prospectively. Five variables were selected that might predict analgesia use: (1) anxiety, (2) request for sedation, (3) chronic use of addictive medications, (4) previous intravenous drug use, and (5) analgesia requirement with previous biopsies. Analgesia and narcotic requirement after liver biopsy were 35% and 15%, respectively. There was a lower average age (43 vs 47) (P = 0.03) and a higher Knodell score (7.2 vs 5.8) (P = 0.04) in those that required analgesics. The diagnosis of HCV (P = 0.007), previous intravenous drug abuse (IVDA) (P = 0.0001), request for medications before biopsy (P = 0.02), anxiety expressed (P = 0.0002), and chronic use of addictive medications (P = 0.03) predicted analgesia use. Previous IVDA (OR 9.3) and anxiety (OR 3.9) are predictive of pain medication use. In conclusion, patient characteristics play an important role in pain medication requirement after liver biopsy. If pain after liver biopsy is to be reduced, one has to understand the predisposing factors. Further studies utilizing behavior modification are warranted.