Postinterventional Patient Comfort After Uterine Artery Embolization and Superior Hypogastric Nerve Block.

Abstract

To evaluate the duration and effect of superior hypogastric nerve block (SHNB) with ropivacaine and clonidine on postinterventional pain levels and opioid requirements in patients undergoing uterine artery embolization. Postinterventional pain levels (numeric rating scale, NRS 0-10) and opioid doses were retrospectively analyzed in 53 patients undergoing transfemoral uterine artery embolization and intraprocedural superior hypogastric nerve block during 24h. A mixture of 150mg of ropivacaine and 150µg of clonidine was used for the block. Postinterventional pain averaged between 1.4 and 2.0 during the first 9h, after which a small but significant increase was observed (NRS 1.7 ± 1.6 vs. NRS 2.6 ± 2.2, p < 0.001). 70% of patients did not exceed a tolerable pain threshold of NRS 4 during the first 9h after the intervention. Thirty-three patients (62%) did not require any opioid medication. Mean iv morphine dose was 3.1 ± 4.7mg, whereas 71% of opioid doses were administered after 9h. Superior hypogastric nerve block using a mixture of ropivacaine and clonidine provides good pain relief for 9h after uterine artery embolization requiring only very low amounts of additional opioids.