Superior Hypogastric Nerve Block for Pain Control after Uterine Artery Embolization: Effect of Addition of Steroids on Analgesia

Circular suture of the uterine serosa and myometrium layer around placental attachment site for refractory postpartum hemorrhage

“…Traditional surgical treatment of refractory PPH often takes a relatively long time and does not have an exact effect, which was dangerous to patients at risk 2, 10, 26 . Uterine artery embolization is widely used in the prevention and treatment of acute uterine bleeding and other obstetrics and gynecology fields, but its complications were unavoidable such as inguinal hematoma, arteriovenous fistula, pseudoaneurysm, anaphylactic shock, pulmonary embolism, and lower extremity artery embolization 27, 28 . At the same time, the uterine and ovarian function decline has the negative impact on the patient's pregnancy next time.…”

“…2,10,26 Uterine artery embolization is widely used in the prevention and treatment of acute uterine bleeding and other obstetrics and gynecology fields, but its complications were unavoidable such as inguinal hematoma, arteriovenous fistula, pseudoaneurysm, anaphylactic shock, pulmonary embolism, and lower extremity artery embolization. 27,28 At the same time, the uterine and ovarian function decline has the negative impact on the patient's pregnancy next time. The existing uterine compression sutures can effectively stop bleeding by compression, but it causes damage to endometrial and also many postoperative complications.…”

Managing Postembolization Syndrome–Related Pain after Uterine Fibroid Embolization

“…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.…”

Management of Postprocedural Uterine Artery Embolization Pain

“…1). 3,29 The addition to overall procedure time is also minimal at around 8 to 10 minutes. 10 The addition of 40 mg of triamcinolone can also prolong SHNB analgesia from around 8 to 10 hours (as is commonly reported) to 33.8 hours.…”

“…10 The addition of 40 mg of triamcinolone can also prolong SHNB analgesia from around 8 to 10 hours (as is commonly reported) to 33.8 hours. 29 Although SHNB has been shown to be less effective at reducing pain relative to epidural anesthesia, a recent double-blind randomized control trial showed SHNB to significantly lower mean postprocedural pain scores immediately after UAE, opiate use, and antiemetics with no major complications as compared with a sham procedure. 13,30 Of note, pain reduction compared with the sham procedure was not significant on arrival at the post-anesthesia care unit (PACU), or at departure from the PACU (►Table 2).…”