For the vast majority of biopsy procedures local anaesthetic is administered following localization of the biopsy site on ultrasound. Either 1% or 2% lidocaine (lignocaine) is commonly used; the volume will depend upon patient build, depth of lesion and patient anxiety. Normally a short period of time, commonly 4–5 min, is allowed to pass so that the anaesthetic can work, after which a small scalpel incision is made in the skin to facilitate the biopsy needle’s introduction, with little or no discomfort to the patient.
In cases of, for example, simple aspiration with a 22-gauge needle or smaller, local anaesthetic is normally unnecessary. Patients who are particularly apprehensive may require preprocedure medication with a  edative such as diazepam or similar anxiolytic agent; however this is not common. Very occasionally  ntravenous analgesia and/or sedation may be required during the procedure; it is often a good idea to have an intravenous cannula in situ prior to biopsy. The use of a general anaesthetic for children is common practice, to enable the procedure to be carried out quickly and accurately while the child remains still.
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