For lumbar punctures, local anesthetics are used, although efficacy in infants is controversial. Young children and some older children and adults benefit from a benzodiazepine. Supplementation with opioids is helpful for some patients, especially when difficulty in performing the procedure is anticipated. Management for bone marrow aspirations and biopsies includes the use, along with local anesthesia, of either general anesthesia or conscious sedation with benzodiazepines and opioids.
Adequate time is necessary for the local anesthetic agent to have full effect.
These strategies alone, however, often do not reduce pain sufficiently.