• Muhammad Akbar Baig
  • Wajiha Javed


Background: Pain is one of the most common and feared complication of percutaneous liver biopsy under local anaesthesia using sonographic guidance. This observational study was set to judge the intensity of pain felt by adult patients presenting for percutaneous liver biopsy with known/suspected underlying hepatic pathology. Methods: This observational cross sectional study which was piloted on 10% of the original sample size was conducted at Aga Khan University Hospital, Karachi. Study population was the adult patients coming for percutaneous liver biopsy at the Department of Radiology. Descriptive statistics were run, data was checked for normality. Means and Standard deviations were done for continuous variables and where data was skewed, median with inter quartile range was computed. Later data was clumped in categories, frequency and percentages were reported for categorical variables. Graphical representation of data was done. Results: A total of 50 patients were recruited. Minimum pain reported on visual analogue scale (VAS) was 0 and maximum as 4. 30% of patients rated 3 and similarly 30% of the people rated 4 on the VAS. Mean pain experienced was 2.7±1.11 and a median of 3 on VAS. This indicates that a minority of patients in our survey had a complaint of mild pain during the procedure. Conclusions: Percutaneous liver biopsy is a very safe procedure and minimal pain was felt by a minority of patients whereas the rest showed satisfaction from the procedure with no post procedural complaints.Keywords: Pain, Visual Analogue scale, percutaneous liver biopsy


Previsani N, Lavanchy D. WHO/CDS/CSR/LYO/2002.2:Hepatitis B. Geneva: World Health Organization; 2002. Hepatitis B

Hepatitis C. Geneva: World Health Organization; 2000. [(accessed August 2008 [Au?3]]. World Health Organization fact sheets. Available at:

Ali SA, Rafe M.J. Donahue, Qureshi H, and Vermund SH. Hepatitis B and hepatitis C in Pakistan: prevalence and risk factors. Int J Infect Dis 2009;13(1):9–19

Ghent CN. Percutaneous liver biopsy : Reflections and refinements . Can J Gastroenterol. 2006;20(2):75–9.

Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD. Liver biopsy. Hepatol 2009;49(3):1017–44.

Siegel CA, Silas AW, Suriawinata AA, van Leeuwen DJ. Liver biopsy 2005: When and how? Cleve Clin J Med 2005;72(3):199–224.

Friedman LS. Controversies in liver biopsy: who, where, when, how, why?. Curr Gastroenterol Rep.2004;6(1):30–6

Sheela H, Seela S, Caldwell C, Boyer JL, Jain D. Liver biopsy: evolving role in the new millennium. J Clin Gastroenterol 2005;39:603–10.

J A Flemming, D J Hurlbut, B Mussari, L C Hookey. Liver biopsies for chronic Hepatitis C: Should nonultrasound-guided biopsies be abandoned? Can J Gastroenterol 2009;23(6):425–30.

Thampanitchawong P, Piratvisut T. Liver biopsy: complications and risk factors. World J Gastroenterol, 1999 August; 5(4):301–30.

Declaration of Helsinki[], cited 27th October 2011, Available from

Sriwatanakul K, Kelvie W, Lasagna L, Calimlim JF, Weis OF, Mehta G. Studies with different types of visual analog scales for measurement of pain. Clin Pharmacol Ther 198334(2):234–9.

Svensson I, Sjostrom B, Haljamae H: Influence of expectations and actual pain experiences on satisfaction with postoperative pain management. Eur J Pain 2001;5(2):125–33.

E. Eisenberg, MD, M. Konopniki, MD, E. Veitsman, MD, R. Kramskay, MD, D. Gaitini, MD, and Y. Baruch, MD, Prevalence and Characteristics of Pain Induced by Percutaneous Liver Biopsy. Anesth Analg 2003;96:1392–6.

Cadranel J, Rufat P, Degos F. Practices of liver biopsy in France: results of a prospective nationwide survey. Hepatol 2000;32:477–80.

Castéra L, Nègre I, Samii K, Buffet C. Pain experienced during percutaneous liver biopsy. Hepatol 1999;30:1529–30.

Meskine N,Vullierme MP,Zappa M,d'Assignies G,Sibert A,Vilgrain V. Evaluation of analgesic effect of equimolar mixture of oxygen and nitrous oxide inhalation during percutaneous biopsy of focal liver lesions: a double-blind randomized study. Acad Radiol 2011;18:816–21.

Kramskay R,Tansky A,Eisenberg E,Veitsman E,Baruch Y. Prophylactic analgesia before percutaneous liver biopsy: a clinical comparative study. Eur J Gastroenterol Hepatol 2011;23:782–6.