Superior Hypogastric Nerve Block in Uterine Fibroid Embolization Patients with Radial Artery Access: Vascular Considerations, Anesthetic Choices, and Rescue Options

Managing Postembolization Syndrome–Related Pain after Uterine Fibroid Embolization

“…The lipid emulsion is thought to work by binding the lipophilic local anesthetic and preventing its binding to cardiac or neural receptors. 34 However, the risk of this in SHNB is thought to be no more severe than the risk with epidural anesthesia because of the use of fluoroscopic guidance to confirm needle location. Visualization of the spatial relationship between the iliocaval junction, aortic bifurcation, and the midinferior L5 vertebral body can be evaluated by magnetic resonance images before the procedure to reduce the risk of IV injection of anesthetic.…”

“…Visualization of the spatial relationship between the iliocaval junction, aortic bifurcation, and the midinferior L5 vertebral body can be evaluated by magnetic resonance images before the procedure to reduce the risk of IV injection of anesthetic. 34 Several procedural steps are also taken to ensure appropriate site for injection.…”