Is bone marrow puncture painful for children?

Bone marrow puncture is a common method to find the cause of a disease. Under normal circumstances, even children will not feel pain during this operation, only a bloating that is not particularly obvious, because an appropriate amount of anesthetic will be injected before the operation; but if the patient is not adapted to the anesthetic or has a low sensitivity, there may be pain, but it is bearable and not very painful.

1. Does it hurt for children to have a bone marrow puncture?

Bone marrow puncture is mainly used to check bone marrow cytology diagnosis and review the effect of treatment for a certain disease. The examination is simple, generally painless, and a little swollen, just like an injection, and it also provides local anesthesia.

2. Indications for bone marrow puncture

1. Diagnosis, differential diagnosis and treatment follow-up of various blood diseases.

2. Unexplained increase or decrease in the number of red blood cells, white blood cells, and platelets, as well as morphological abnormalities.

3. Diagnosis and differential diagnosis of fever of unknown cause may include bone marrow culture and bone marrow smear to look for parasites.

3. Precautions for bone marrow puncture

1. After the puncture needle enters the bone, avoid swinging it too much to avoid breaking it.

2. When puncturing the manubrium, the needle should not be inserted vertically and excessive force should not be used to prevent penetration of the medial bone plate.

3. When aspirating bone marrow fluid, gradually increase the negative pressure. When performing cell morphology examination, the aspirated volume should not be too much, otherwise the bone marrow fluid will be diluted, but it should not be too little either.

4. Bone marrow fluid should be smeared immediately after extraction.

5. Bone marrow biopsy should be performed when multiple dry taps are performed.

Postoperative management of bone marrow puncture

1. Apply pressure to stop bleeding after surgery. For patients with bleeding tendency, prevent the formation of subperiosteal hematoma or continuous bleeding.

2. Do not wash the puncture site with water within 3 days after the operation to prevent infection.

5. Misunderstandings about bone marrow puncture

Some people mistakenly believe that bone marrow puncture is a "spinal tap", that is, a lumbar puncture to extract cerebrospinal fluid, and they think that this can cause paraplegia. In fact, the two are not the same thing, and the puncture sites are completely different. The site of lumbar puncture is the lumbar part of the spine (backbone), that is, the needle is inserted into the space between the lumbar vertebrae. In fact, as long as you master the essentials and follow standardized operations, it is very safe in most cases.

The most common problem encountered in bone marrow puncture is "unsatisfactory sampling". The most common reason is that the puncture needle does not actually enter the bone marrow cavity, and the content extracted is actually the blood in the blood vessels of nearby tissues, or although it enters the bone marrow cavity, too much content is extracted, which will damage the blood vessels in the bone marrow cavity, causing the peripheral blood and bone marrow fluid in the blood vessels to mix, resulting in "dilution" of the bone marrow fluid, commonly known as "mixed blood". The above two situations cause the smear to look like a blood smear when observed under a microscope. As long as the puncture operator masters the essentials, including correct positioning, ensuring that the puncture needle is in the bone marrow cavity, and extracting the contents without too much blood, and the patient is under good anesthesia, overcomes fear, and cooperates with the operation, most bone marrow punctures can be completed smoothly and very safely. It is very rare for complications such as anesthesia accidents (allergies), local bleeding, and infection to occur.