• fine needle aspiration biopsy;
  • pain scale;
  • neck mass;
  • ultrasound;
  • local anesthesia


The purpose of this study was to evaluate the pain levels associated with ultrasound-guided fine-needle aspiration biopsy (FNAB) of neck masses.


The pain immediately and 5 minutes after the procedure without use of local anesthesia was evaluated via 100-mm visual analog scale (VAS), 11-point numeric rating scale (NRS), and 4-category verbal rating scale (VRS) in 154 patients.


The mean scores (SDs) for VAS, NRS, and VRS immediately versus 5 minutes after the procedure were 30.5 (24.4) versus 7.3 (13.7), 3.3 (2.2) versus 0.8 (1.6), and 1.3 (0.6) versus 0.3 (0.6), respectively (all ps < .001). Immediately after ultrasound-guided FNAB, the pain scores associated with lymph node aspiration (VAS, 36.7 [25.5]; NRS, 3.9 [2.1]) were significantly higher (both ps < .05) than those associated with thyroid nodule aspiration (VAS, 25.0 [21.2]; NRS, 2.8 [2.0]).


Ultrasound-guided FNAB of thyroid nodules was less painful than that of cervical lymphadenopathy. Most patients tolerated mild transient pain after the procedure without use of local anesthesia. Nevertheless, local anesthesia was necessary for the small subgroup of patients who experienced significant pain. © 2013 Wiley Periodicals, Inc. Head Neck 36: 252–256, 2014