Abstract
BackgroundTo investigate if intra-arterial lidocaine administrated immediately after the embolisation endpoint reduces the pain.MethodsForty patients were randomised and 36 completed the study for purposes of analysis. In one group, the patients got 1% 10 ml lidocaine (100 mg) administered into each uterine artery immediately after embolisation with microspheres. The other group was embolised without supplementary lidocaine. The patients scored their pain on a visual analogue scale (VAS) 2 h, 4 h, 7 h, 10 h and 24 h after embolisation, and the total amount of used morphine was noted. Three-month follow-up MRI control was scheduled for all the patients to investigate the infarction rate.ResultsEmbolisation was performed without any complications and with embolisation of both uterine arteries in all cases. Intra-arterial lidocaine was administered in all 20 patients without complications, and 20 patients in a control group did not receive lidocaine intra-arterial. VAS schemes showed a significant reduction in pain experience 2 h after UFE where mean pain score in the lidocaine group was 42.7 ± 21.4 compared with the control group in which the mean pain score was 61.1 ± 20.4 (p < 0.02). There was no significant difference in pain score 4 h, 7 h, 10 h and 24 h after UFE. In the lidocaine group, the mean amount of used morphine was significantly less with 11.2 mg compared with 20.2 mg in the control group (p < 0.03). Three months of MR follow-up control showed no significant difference in the grade of fibroid infarction.ConclusionIntra-arterial Lidocaine administration after embolisation is safe and effective in reducing post-procedural pain in the early hours and opioid usage in the first 24 h following UAE.
Highlights
Uterine fibroid embolisation (UFE) is a well-described and well-established interventional radiology procedure to treat symptomatic uterine fibroids
The present study aims to investigate if intra-arterial lidocaine administrated in the uterine arteries immediately after UFE reduces the pain
UFE was performed without complications and with embolisation of both uterine arteries as intended
Summary
Uterine fibroid embolisation (UFE) is a well-described and well-established interventional radiology procedure to treat symptomatic uterine fibroids. The pain usually decreases and the majority of patients are discharged within 24 h after UFE without pain. Few studies are describing that intra-arterial lidocaine can reduce the pain during embolisations including UFE (Noel-Lamy et al 2017; Keyoung et al 2001; Lee et al 2001). Another more invasive analgesic technique to reduce or eliminate embolization-induced ischemic pain is Duvnjak and Andersen CVIR Endovascular (2020) 3:10 hypogastric nerve blockade which has shown promising results (Binkert et al 2015; Yoon et al 2018). To investigate if intra-arterial lidocaine administrated immediately after the embolisation endpoint reduces the pain
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