Intraarterial Lidocaine for Pain Control after Uterine Artery Embolization for Leiomyomata

Keyoung, J. Andrew; Levy, Elliot; Roth, Antoinette R.; Gomez-Jorge, Jackeline; Chang, Thomas; Spies, James B.

doi:10.1016/s1051-0443(07)61592-9

Cited by 44 publications

(32 citation statements)

References 23 publications

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“…Previous studies [14][15][16] showed that morphine PCA provided superior PI ratings after UAE in a nonrandomized setting compared with fentanyl PCA [16]. In the remaining randomized controlled studies, morphine PCA was associated with greater early PI compared with target-controlled remifentanil [15] and when compared with morphine PCA combined with localized intra-arterial lidocaine injection [19]. Morphine PCA alone showed no difference in PI compared to a combination of morphine and ketamine PCA [14].…”

Section: Discussionmentioning

confidence: 97%

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A Randomized, Double-Blind, Placebo-Controlled Study of Preemptive Oral Oxycodone with Morphine Patient-Controlled Anesthesia for Postoperative Pain Management in Patients Undergoing Uterine Artery Embolization for Symptomatic Uterine Fibroids

Konstantatos

Kavnoudias

Stegeman

et al. 2014

Cardiovasc Intervent Radiol

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Purpose To evaluate the analgesic efficacy of oral premedication of oxycodone in a group of patients undergoing elective uterine artery embolization under sedation for fibroid disease. Methods Thirty-nine patients (mean age 42.3 years) were prospectively randomized 1:1 to receive 20 mg oxycodone or placebo orally immediately before their procedure. At the commencement of the procedure, patients were provided with a patient-controlled analgesia device for 24 h, programmed to deliver 1 mg boluses of intravenous morphine with a 5 min lockout. Mean visual analog scale pain intensity ratings (0-100 mm) were measured from both groups and evaluated over 0 to 6 h as the primary end point. Other measured parameters included opioid-related side effects and eligibility for discharge (NCT00163930; September 12, 2005). Results Early pain intensity did not vary significantly between the active and placebo groups [mean (standard deviation): 3.2 (2.5) vs. 3.1 (2.2), p = 0.89]. The oxycodone group, however, experienced significantly more nausea (p = 0.035) and a greater incidence of vomiting (p = 0.044). Overall opioid requirement over 24 h, measured as oral morphine equivalent, was greater in the oxycodone group (median [interquartile range]: 64.5

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Section: Discussionmentioning

confidence: 97%

“…Favorable descriptions of epidural analgesia for UAE exist only in case series without reference to control groups [17,18], while intra-arterial lidocaine injection was associated with significantly lower pain scores but no reduction in morphine PCA requirements in a randomized doubleblind setting [19].…”

Section: Introductionmentioning

confidence: 99%

A Randomized, Double-Blind, Placebo-Controlled Study of Preemptive Oral Oxycodone with Morphine Patient-Controlled Anesthesia for Postoperative Pain Management in Patients Undergoing Uterine Artery Embolization for Symptomatic Uterine Fibroids

Konstantatos

Kavnoudias

Stegeman

et al. 2014

Cardiovasc Intervent Radiol

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“…However, uterine arteries do not appear to respond to lidocaine in the same way as hepatic arteries following injection of intra-arterial lidocaine; this may be due to their need to meet the demands of a gravid uterus (17). Keyoung et al injected 200 mg of lidocaine in 10 consecutive patients (while eight received placebo) prior to uterine artery embolization (UAE) for leiomyomata (17). Lidocaine was found to significantly improve subjective pain reported by patients but not the amount of analgesia required following the procedure.…”

Section: Use Of Intra-arterial Local Anestheticsmentioning

confidence: 99%

“…Similar to TACE, pain is thought to result from leiomyoma ischemia, spasm, and parenchymal swelling (16). However, uterine arteries do not appear to respond to lidocaine in the same way as hepatic arteries following injection of intra-arterial lidocaine; this may be due to their need to meet the demands of a gravid uterus (17). Keyoung et al injected 200 mg of lidocaine in 10 consecutive patients (while eight received placebo) prior to uterine artery embolization (UAE) for leiomyomata (17).…”

Section: Use Of Intra-arterial Local Anestheticsmentioning

confidence: 99%

Pain Management in Interventional Radiology: An Introduction

Bauer

Ray²

2008

Pain Management in Interventional Radiology

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“…According to the literature, UFE is very effective in diminishing heavy menstrual bleeding and stopping myoma growth [1][2][3][4]. One of the principal side effects in the short term is pain [4][5][6]. Pain can happen during and immediately after the procedure.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of intra-arterial anesthesia for uterine fibroid embolization using dilute lidocaine

Zhan

Wang

et al. 2005

Eur Radiol

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A modified protocol of uterine fibroid embolization (UFE) is proposed for alleviating the postinterventional pain. This randomized and double-blinded clinical trial is to evaluate the effectiveness of intra-arterial infusion of dilute lidocaine for postinterventional pain relief in UFE. Forty-six patients who underwent UFE were randomly grouped equally. In the test group, after the poly(vinyl alcohol) embolization was complete, a dilute lidocaine solution with 40 mg in 6.0 ml, 3.0 ml for each side or 4.0 and 2.0 ml for two sides, was given through the catheter. In the control group, the patients received 6.0 ml of saline solution as a placebo. A simple pain degree classification method for patient self-evaluation was developed. A questionnaire was completed by each patient to record the degree of pain during five periods; these were during the procedure, the first 12 h, the second 12 h, between 24 and 48 h, and between 48 and 72 h. The numbers of patients with the same degree of pain in the five time segments from the two groups were statistically compared. Compared with the control group, the patients in the test group experienced less pain within 48 h after the procedure (p<0.01). The results suggest that this improved UFE protocol is a simple approach to prevent the acute postinterventional pain of UFE.

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Intraarterial Lidocaine for Pain Control after Uterine Artery Embolization for Leiomyomata

Cited by 44 publications

References 23 publications

A Randomized, Double-Blind, Placebo-Controlled Study of Preemptive Oral Oxycodone with Morphine Patient-Controlled Anesthesia for Postoperative Pain Management in Patients Undergoing Uterine Artery Embolization for Symptomatic Uterine Fibroids

A Randomized, Double-Blind, Placebo-Controlled Study of Preemptive Oral Oxycodone with Morphine Patient-Controlled Anesthesia for Postoperative Pain Management in Patients Undergoing Uterine Artery Embolization for Symptomatic Uterine Fibroids

Pain Management in Interventional Radiology: An Introduction

Effectiveness of intra-arterial anesthesia for uterine fibroid embolization using dilute lidocaine

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