Inclusion Criteria:

- Any newly diagnosed patient at the Arthur G. James Cancer Hospital and Richard J.
Solove Research Institute whose Hematologist or Oncologist has ordered them to
undergo a bilateral bone marrow biopsy for diagnostic and /or treatment purposes.

- 18 years of age or older.

Exclusion Criteria:

- Pregnant or Lactating women.

- Patients with allergies to local anesthetics.

- Patients requiring a unilateral bone marrow biopsy.

- Patients that cannot lie flat in either the supine or prone position.

- Patients that have used any of the following: narcotics, non-narcotic analgesia or an
anti-anxiolytic medication on the same calendar day as the scheduled procedure. These
medications will not be given to the participant at any time before or during the
procedure.

- Patients on long-acting narcotic medication.

- Patients with neuropathy in the posterior iliac crest area

- Patients with a platelet count less than 20,000.

- Patients who are cognitively impaired or unable to self-report pain using the VAS.

- Patients with known bone metastasis.