The perception of pain associated with thyroid fine needle aspiration before and after the procedure

The idea of fine needle aspiration cytology (FNAC), which is considered the gold standard in the evaluation of thyroid nodules, occasionally elicits fear on the part of patients that often results in delays to the procedure. Our aim was to analyze the difference between the intensity of pain imagined or expected, before and the real pain experienced during the procedure, and also some of the factors influencing it.

Materials and methods. Questionnaires were used, answered by 103 patients. Sampling was performed without local anesthesia using 25G diameter needles. The first page of the questionnaire was completed before and the second page after the intervention. A numerical pain scale was used to indicate the expected (pre-procedure) and perceived (post-procedure) intensity of pain.

Results. The mean age of the patients was 54 years, and 76% had not yet undergone such procedure. In all patients, the intensity of pain experienced during the intervention itself was less than what patients expected (p <0.0001). First-time goers expected greater pain compared to those who had already underwent such a procedure (p = 0.0163). For those who had already underwent such a procedure, there was no difference between the intensity of expected pain and the intensity of experienced pain (p = 0.6307). The pain perception decreased with age, both before (r2 = 0.01925) and during the procedure (r2 = 0.03045). Patients who graduated only primary school were more afraid of the pain (58%) as opposed to graduates of secondary and higher education (23–24%), members of the latter group were rather preoccupied with the outcome of the cytological report.

Discussions, conclusions. We studied the intensity of expected and experienced pain associated with thyroid aspiration cytology, and some of the factors that may influence this. The level of expected pain appears to be influenced by patient awareness, as those who underwent for the first time a thyroid aspiration, expected significantly more pain than they actually experienced. In conclusion, the general characteristics of patients who experienced greater pain after the procedure were those with low levels of awareness or complete absence thereof, younger age and lower levels of education. We believe that proper patient education significantly reduces the procrastination of the procedure of thyroid FNAC and alleviates patients ’anxiety, thereby aiding them to receive prompt and appropriate care.