How can we reduce the pain associated with FNA biopsy? Comparison of parallel and perpendicular method

To assess the tolerability of two different biopsy methods for thyroid nodules in a patient with nodular thyroid disease (NTD). The study included 58 consecutive patients who had NTD from June 2014 to October 2015. Each patient had, at least, two thyroid nodules were located in two lobes. Parallel and perpendicular fine-needle aspirations (FNAs) were performed. The mean maximum diameters of the assessed thyroid nodules using ultrasound (US) in parallel and perpendicular techniques were 23 +/- A 7 and 22 +/- A 6 mm, respectively. Nodule sizes were not significantly different (p > 0.05). For the parallel and perpendicular techniques, the mean numeric rating scale (NRS), verbal rating scale (VRS), and visual analog scale (VAS) values were 3.6 +/- A 1.9, 2.6 +/- A 1.1, and 17.2 +/- A 13 with 6.6 +/- A 1.7, 3.4 +/- A 0.5, and 37.8 +/- A 18, respectively. All these values were statistically significant (p < 0.001); there were no statistical differences between females and males in terms of three pain scales (p < 0.001). Patients experienced significantly less pain when undergoing FNA of NTD using the parallel technique as opposed to the perpendicular technique. Therefore, we believe that FNA using parallel technique is preferable for NTD patients.