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      Journal of Pain Research (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on reporting of high-quality laboratory and clinical findings in all fields of pain research and the prevention and management of pain. Sign up for email alerts here.

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      Differences in pain perception during open muscle biopsy and Bergstroem needle muscle biopsy

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          Abstract

          Purpose

          Open surgical muscle biopsy (OB) and percutaneous Bergstroem needle muscle biopsy (NB) are equally accepted procedures. However, there are no data comparing intraprocedural pain for both techniques. We designed this prospective trial to test the hypothesis that the less invasive NB causes less intraprocedural pain than OB.

          Methods

          In a two-center prospective trial, 33 patients underwent both procedures in one session. All patients quantified intraprocedural pain using the numeric rating scale (NRS). Mean NRS values were calculated along with the difference in NRS values (ΔNRS) between both types of biopsies.

          Results

          Mean NRS values were 4.5 (±2.7 standard deviation [SD]) for NB and 3.2 (±2.1) for OB ( P=0.02). Of the patients, 57.6% described the ΔNRS as ≤2 NRS points. Regarding the pain categories “mild” (NRS 0–3), “moderate” (NRS 4–7), and “severe” (NRS 8–10), no significant difference was observed between NB and OB. Patients who found NB to be more uncomfortable were more likely to quantify the ΔNRS as >2 NRS points than patients finding OB more uncomfortable.

          Conclusion

          Our results do not support the hypothesis that intraprocedural pain in NB is less than in OB. When informing the patient about both types of muscle biopsies, the amount of intraprocedural pain should not serve as a differentiating characteristic.

          Most cited references16

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          Statistical methods for assessing agreement between two methods of clinical measurement.

          In clinical measurement comparison of a new measurement technique with an established one is often needed to see whether they agree sufficiently for the new to replace the old. Such investigations are often analysed inappropriately, notably by using correlation coefficients. The use of correlation is misleading. An alternative approach, based on graphical techniques and simple calculations, is described, together with the relation between this analysis and the assessment of repeatability.
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            Percutaneous needle biopsy of skeletal muscle in physiological and clinical research.

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              Suction-modified Bergström muscle biopsy technique: experience with 13,500 procedures.

              Bergström needle muscle biopsies have been used by exercise physiologists for over 35 years but have been less accepted by neuromuscular clinicians due to size concerns. We retrospectively reviewed over 13,500 muscle Bergström needle biopsies done over a 21-year period to determine sampling success, patient/subject experience, and complications. We compared sample yield between two different needles (Bergström vs. UCH), with and without suction modifications. Needle biopsies adequate for histology and enzymology were obtainable from the vastus lateralis, deltoid, biceps brachii, soleus, and medial gastrocnemius muscles, with a success rate of >99.9% and a minor complication rate of 0.15%. Approximately 450 muscle fibers were submitted for histologic assessment; suction modification and use of the Bergström vs. UCH needle were associated with larger sample size (P < 0.05). The suction-modified Bergström needle muscle biopsy technique is safe and provides an adequate sample size for histologic, ultrastructural, DNA, and enzyme analysis.
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                Author and article information

                Journal
                J Pain Res
                J Pain Res
                Journal of Pain Research
                Journal of Pain Research
                Dove Medical Press
                1178-7090
                2014
                17 November 2014
                : 7
                : 645-650
                Affiliations
                [1 ]Department of Neurosurgery, Charité – Universitätsmedizin Berlin, Berlin, Germany
                [2 ]Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany
                [3 ]Department of Neurology, Universitätsklinikum Ulm, Ulm, Germany
                Author notes
                Correspondence: Julius Dengler, Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum (CVK), Augustenburger Platz 1, 13353 Berlin, Germany, Tel +49 163 674 5825, Fax +49 304 5056 0900, Email julius.dengler@ 123456charite.de
                Article
                jpr-7-645
                10.2147/JPR.S69458
                4242498
                25429236
                62ece051-d55b-4d4a-b476-f0bda625e63e
                © 2014 Dengler et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License

                The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Original Research

                Anesthesiology & Pain management
                bergstroem needle,muscle biopsy,percutaneous,pain,numeric rating scale

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