Preparation

The basis of a successful bone marrow puncture is the medical consultation at the beginning of the cooperation between the doctor and the patient. In this conversation, which usually takes place a few days before the bone marrow aspiration, the important points for the procedure are clarified. This also includes relevant pre-existing conditions such as a blood coagulation disorder, the use of certain medications such as blood thinners or substances harmful to the bone marrow, family circumstances and allergies or intolerances.

If necessary, some of the medications may have to be discontinued or further preparations made. A new appointment will then be made. Sobriety with regard to food and drink is not necessary.

Sequence/feedthrough

If all problematic drugs have been discontinued before the puncture, the normal course of the puncture can be started. For this purpose, the person to be punctured is usually given a sedative and an analgesic beforehand. The sedative is intended to ensure that fewer problems are caused by movement, fear or the like during the procedure.

The analgesic is intended to relieve the pain that occurs after bone marrow puncture. All the necessary materials for the puncture are also provided. Since the risk of infection is very high during bone marrow aspiration, sterile working conditions must be ensured.

Special precautions are also taken for this. A local anesthetic is then used. This anesthetic is injected into the skin under sterile conditions.

It should be applied around the entire area where the puncture is to be made, so that no pain is felt during the puncture and bone marrow aspiration. If the local anesthetic takes effect, the puncture can be started, also under sterile conditions. For the collection of bone marrow from the iliac crest, the patient must lie down on the other side.

For a puncture on the right side, the patient lies on the left side. The legs should also be slightly bent.When bone marrow is taken from the sternum, the patient lies on his back. The tip of the needle or punch is now pushed through the skin and the outer bone layer until it reaches the bone marrow.

At this point, several jerks are used to suck up bone marrow. This can be associated with pain, but is usually successful. In the process, the components such as cells, blood and fat are absorbed.

This only takes a few minutes. After the needle or punch is removed, a light compression bandage is applied. In addition, one should not move much for the next quarter of an hour.

Overall, one day of rest shows good results. Both of these measures are intended to reduce postoperative pain, as less blood gets into the tissue. A high degree of cleanliness should continue to be maintained in order to avoid promoting infection.

The impairments disappear completely within two weeks. The tissue sample is sent to the laboratory or to the pathologist for evaluation under the microscope or immunohistochemically. General anesthesia is not necessarily required for a bone marrow puncture.

However, it may be necessary in cases of great anxiety or some other indications. However, this is mostly tried to avoid, since general anesthesia is an immense burden for the body. This can be even more drastic in people who already have an immune deficiency. Instead of a general anesthesia, an attempt is made to prevent the pain by using a local anesthetic. For this purpose, an anesthetic is injected into the area of the subsequent puncture with a syringe, which takes effect after a short time.