All patients were lying face down with their hands positioned under the head (based on the French Society of Hematology guidelines) [28 ]. Local anesthesia was performed with a lidocaine injection (1 vial containing 20 mL had a concentration of 10 mg/mL). Biopsy was then performed on the posterior iliac crest with a classic trocard (Jamshidi or Monoject bone marrow biopsy needle).
In the MEOPA group, administration was started at the same time as the local anesthesia. In the VR group, a 5-minute demonstration session was proposed on the day of randomization to assess tolerance before the biopsy, and the program was started 5 minutes before anesthesia with a maximum duration of 40 minutes. In cases of intolerable pain during the procedure, salvage treatment with a second local injection of lidocaine and/or paracetamol (1 g) or alprazolam (0.25 mg) was proposed.
In the MEOPA group, administration was started at the same time as the local anesthesia. In the VR group, a 5-minute demonstration session was proposed on the day of randomization to assess tolerance before the biopsy, and the program was started 5 minutes before anesthesia with a maximum duration of 40 minutes. In cases of intolerable pain during the procedure, salvage treatment with a second local injection of lidocaine and/or paracetamol (1 g) or alprazolam (0.25 mg) was proposed.
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