Dr.Guttler’s Thyroid Patient Blog Post; Pain from Fine Needle Biopsies.
1. FNA is done with or without local anesthetic. 1-5 passes into the nodule is done.
2. Liu T. et al reviewed factors leading to pain. Endo.Practice 28 (2022) 628.
3. Pain level scores were evaluated.
4. Pain factors included number of passes,use of aspiration, perpendicular needle placement, and failue to use safety devices.
5. Larger needle, operator experience or patient education were not pain causing factors.
6. SubQ lidocaine was better than topical.
7. In my practice the key factor is the use of Small needles #27-25 and capillary action without suction.
8. Suction is only used for “dry taps” to get a sample.
9. Pain is minor when using the smallest needle needed to obtain a small sample to smear on slides.
10. I have 40+ years experience doing thyroid FNA.
11. 310-393-8860 oe email to firstname.lastname@example.org.