Bone marrow biopsy under conscious sedation

This leaflet is for patients who have an appointment for a bone marrow biopsy.

What is a bone marrow biopsy?

This is a procedure to collect and examine bone marrow, the spongy tissue inside some of your larger bones.

This will be carried out under intravenous sedation. This means that we will inject medication into your vein to give you pain relief and to make you drowsy.

Preparing for intravenous sedation

It is very important that you follow these instructions to ensure your comfort and safety.

• Do not eat for 4 hours before the procedure.
• You can drink water (or dilute fluids if you are unable to drink water) up to the time of the procedure (please avoid tea and coffee).
• Do not take any blood thinning medications such as warfarin, rivaroxaban (Xarelto), apixaban (Eliquis), edoxaban (Lixiana) or dabigatran (Pradaxa) on the morning of your procedure. This can be re-started in the evening following your procedure.
• Inform a member of staff if you have any drug allergies or intolerances.
• Wear loose fitting clothes and flat comfortable shoes.
• If you are having your procedure as an outpatient, arrange for someone to collect you from the Haematology Day Unit in the Sir William Rous Unit, Kingston Hospital, after your procedure.
• Arrange for someone to stay with you for 24 hours after your procedure because the sedation will still be in your system and will affect your judgement.

What will happen on the day?

Outpatients

When you arrive at the Haematology Day Unit you must report to the reception desk to check in. You will be met by your nurse who will take care of you during your stay and give you a wristband.

Your details, observations (pulse, temperature, breathing rate and blood pressure) and weight will be recorded and closely monitored throughout and after the procedure.

We will ask you to sign a consent form.

We will inject a medicine called Midazolam into your vein to provide you with adequate sedation (to make you drowsy) and analgesia (pain relief). You will still be able to respond to instructions but may not be able to remember the procedure afterwards.

There will be 2 doctors and 1 specialist nurse attending to you. One doctor will perform the bone marrow biopsy and the other will monitor the sedation.

If you are anxious about having the biopsy and would like a relative/friend to be present with you, please discuss this in advance with your haematology clinical nurse specialist. We cannot guarantee that this will be possible, but will do our best to ensure you are supported.

Inpatients

This will be similar to the outpatient process above, but it will take place on the haematology ward instead of the Haematology Day Unit.

What happens after the procedure?

Once you have fully recovered, we will offer you some refreshments.

You will need to stay in the unit for 1 to 2 hours after your procedure to ensure that you are fully recovered from your sedation.

Your nurse will give you advice on aftercare, for example, pain relief.

Your nurse or doctor will tell you when to start taking your usual medications again.

What will happen next?

During the 24 hours after your procedure, we advise that you:

If you have questions before you come in for your biopsy, please contact us using the numbers below.

You can find a map of the hospital showing you how to get to the William Rous Unit on the home page of the Kingston Hospital website www.kingstonhospital.nhs.uk

_{Image provided by Cancer Research UK / Wikimedia Commons}

Contacts

Haematology Day Unit	020 8934 2999
Kingston Hospital Switchboard	020 8546 7711