Intraprocedural Superior Hypogastric Nerve Block Allows Same-Day Discharge following Uterine Artery Embolization

Pereira, Keith; Morel-Ovalle, L.; Wiemken, Timothy; Kazmi, Sakina; Rode, Siddharth; Hardy, Anna K.; Vaheesan, K.

doi:10.1016/j.jvir.2019.08.017

Cited by 20 publications

(11 citation statements)

References 13 publications

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“…The efficacy of SHPB has been demonstrated for the control of pelvic pain after UAE with reduced analgesic requirements and same-day discharge 7,8,13 . In 2004, a study of 139 patients with SHPB after UAE was the first time for pelvic pain control 11 .…”

Section: Discussionmentioning

confidence: 99%

“…Severe pelvic pain is the most common adverse effect in the first 8 to 12 hours after UAE due to myoma ischemia and infarction 7 . Pain control after UAE is critical for a good clinical outcome and early patient discharge 8 . In 1990, Plancarte et al 9 first described superior hypogastric plexus block (SHPB) with fluoroscopic guidance for the management of oncologic pelvic pain.…”

Section: Introductionmentioning

confidence: 99%

“…In middle-or low-income countries such as Mexico, where public health infrastructure is insufficient, and there is limited availability of narcotic analgesics and embolizing materials such as spheres or catheters, UAE is performed with materials such as gelatin sponge, which has been effective and low cost [14][15][16] . SHPB performed with fluoroscopic guidance increases radiation exposure to the medical staff and patients 8 . Therefore, this case series describes the experience of pelvic pain management with ultrasound-guided SHPB after UAE in patients with symptomatic myomas.…”

Section: Introductionmentioning

confidence: 99%

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Pelvic pain management with ultrasound-guided superior hypogastric plexus block (SHPB) after uterine artery embolization for symptomatic myomatosis

Cobos-Rojas¹,

Bernardino-Garcia²,

Bolon-Ojeda³

2022

JMEXFRI

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Introduction:Severe pelvic pain is the most common adverse effect after uterine artery embolization (UAE) for symptomatic myomas. The aim of this case series is to describe pelvic pain management with ultrasound-guided superior hypogastric plexus block (SHPB) in patients treated with UAE for symptomatic myomas. Material and Methods: We present a case series of women with symptomatic uterine myomas treated with UAE and ultrasound-guided SHPB. The visual analog scale (VAS) was used to assess pelvic pain with a rating of minimal (0-2), moderate (3-7), and severe (8-10). The initial VAS was recorded immediately after UAE, and the final VAS twelve to fourteen hours after SHPB and before discharge. Results: Eighteen cases of ultrasound-guided SHPB after UAE were included. A gelatin sponge was used for embolization in 16 women and polidocanol (3%) was added in two cases. Ultrasonographic-guided SHPB was performed with a Chiba 16-gauge needle in 14 patients and a 22-gauge in four cases. The adequate needle tip placement in the anterior wall of L5 was confirmed by fluoroscopy. The mean age of the women was 40.38 ± 7.6 years. The mean initial VAS was mild (1.2 ± 2.2) similar to the final VAS (2.5 ±1.8). The mean number of myomas was 2.4 ± 1.6, and the mean uterine volume was 811.5 ± 599.04 mL. The relevant aspects of the UAE and ultrasound-guided SHPB of specific cases are presented. Conclusion: This report is the first to demonstrate the efficacy of ultrasound-guided SHPB for managing pelvic pain after UAE in patients with symptomatic myomas.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pelvic pain management with ultrasound-guided superior hypogastric plexus block (SHPB) after uterine artery embolization for symptomatic myomatosis

Cobos-Rojas¹,

Bernardino-Garcia²,

Bolon-Ojeda³

2022

JMEXFRI

View full text Add to dashboard Cite

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“…11 Studies have also shown a significant reduction in postprocedural morphine use and mean opioid requirements with shorter hospital stays. 31,32 Moreover, some studies have shown that the addition of steroids (40 mg of triamcinolone to 20 mL of 0.5% bupivacaine block) can prolong the duration of SHNB analgesia from 8 to 12 hours to an average of 33.8 hours post-UAE. 33 In our anecdotal experience, patients who undergo SHNBs are able to be discharged home the same day endorsing appropriate pain control.…”

Section: Superior Hypogastric Nerve Blockmentioning

confidence: 99%

Managing Postembolization Syndrome–Related Pain after Uterine Fibroid Embolization

Chan

Garcia-Reyes

Cronan

et al. 2021

Semin intervent Radiol

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“…6 Although effective, opiate PCA is associated with nausea, drowsiness, and constipation prompting some providers to employ more local methods of pain control such as SHNB, which has been shown to decrease the need for PCA. 38 Many studies have been conducted analyzing variations on medications in the PCA regimen and its effect on post-UAE pain. A prospective nonrandomized trial showed that morphine PCA was superior to fentanyl PCA at controlling pain with the possibility of increased nausea.…”

Section: Postoperative Managementmentioning

confidence: 99%

Management of Postprocedural Uterine Artery Embolization Pain

Commander

Burke

2021

Semin intervent Radiol

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Intraprocedural Superior Hypogastric Nerve Block Allows Same-Day Discharge following Uterine Artery Embolization

Cited by 20 publications

References 13 publications

Pelvic pain management with ultrasound-guided superior hypogastric plexus block (SHPB) after uterine artery embolization for symptomatic myomatosis

Pelvic pain management with ultrasound-guided superior hypogastric plexus block (SHPB) after uterine artery embolization for symptomatic myomatosis

Managing Postembolization Syndrome–Related Pain after Uterine Fibroid Embolization

Management of Postprocedural Uterine Artery Embolization Pain

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