Novel pain management strategy for uterine fibroid embolization
Abstract Background Uterine fibroid embolization can be associated with significant pain due to fibroid ischemia and interventions of the procedure itself. Fentanyl and midazolam are commonly provided for sedation and pain relief, but are not tolerated by all patients. This report outlines a novel p...
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2025-01-01
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Series: | CVIR Endovascular |
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Online Access: | https://doi.org/10.1186/s42155-025-00516-3 |
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author | Elaine Ho Kiat Tsong Tan |
author_facet | Elaine Ho Kiat Tsong Tan |
author_sort | Elaine Ho |
collection | DOAJ |
description | Abstract Background Uterine fibroid embolization can be associated with significant pain due to fibroid ischemia and interventions of the procedure itself. Fentanyl and midazolam are commonly provided for sedation and pain relief, but are not tolerated by all patients. This report outlines a novel pain management strategy for uterine fibroid embolization in a patient who could not receive either opioids or benzodiazepines. Methods A 51 year old woman presenting with menorrhagia due to uterine fibroids was referred to interventional radiology for embolization. She was allergic to most opiates and had previously become agitated with IV midazolam, resulting in termination of a previous attempt at embolization. Thus, a combination of three analgesic modalities was used: intraarterial ropivacaine in the uterine arteries, superior hypogastric nerve block with ropivacaine, and intravenous acetaminophen. The patient underwent successful embolization and reported only intermittent pain of 1–2 out of 10 intensity. Discussion This combined analgesic cocktail represents a novel alternative to traditional sedation for uterine fibroid embolization and may serve as a viable option for patients with similar contraindications. |
format | Article |
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institution | Kabale University |
issn | 2520-8934 |
language | English |
publishDate | 2025-01-01 |
publisher | SpringerOpen |
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series | CVIR Endovascular |
spelling | doaj-art-b4e71338a1674ceb8c4b0cb906fe63832025-01-26T12:54:08ZengSpringerOpenCVIR Endovascular2520-89342025-01-01811410.1186/s42155-025-00516-3Novel pain management strategy for uterine fibroid embolizationElaine Ho0Kiat Tsong Tan1Department of Medical Imaging, Faculty of Health Sciences, McMaster UniversityDepartment of Medical Imaging, Faculty of Health Sciences, McMaster UniversityAbstract Background Uterine fibroid embolization can be associated with significant pain due to fibroid ischemia and interventions of the procedure itself. Fentanyl and midazolam are commonly provided for sedation and pain relief, but are not tolerated by all patients. This report outlines a novel pain management strategy for uterine fibroid embolization in a patient who could not receive either opioids or benzodiazepines. Methods A 51 year old woman presenting with menorrhagia due to uterine fibroids was referred to interventional radiology for embolization. She was allergic to most opiates and had previously become agitated with IV midazolam, resulting in termination of a previous attempt at embolization. Thus, a combination of three analgesic modalities was used: intraarterial ropivacaine in the uterine arteries, superior hypogastric nerve block with ropivacaine, and intravenous acetaminophen. The patient underwent successful embolization and reported only intermittent pain of 1–2 out of 10 intensity. Discussion This combined analgesic cocktail represents a novel alternative to traditional sedation for uterine fibroid embolization and may serve as a viable option for patients with similar contraindications.https://doi.org/10.1186/s42155-025-00516-3Uterine fibroid embolizationUterine artery embolizationFibroidEmbolizationPain managementNerve block |
spellingShingle | Elaine Ho Kiat Tsong Tan Novel pain management strategy for uterine fibroid embolization CVIR Endovascular Uterine fibroid embolization Uterine artery embolization Fibroid Embolization Pain management Nerve block |
title | Novel pain management strategy for uterine fibroid embolization |
title_full | Novel pain management strategy for uterine fibroid embolization |
title_fullStr | Novel pain management strategy for uterine fibroid embolization |
title_full_unstemmed | Novel pain management strategy for uterine fibroid embolization |
title_short | Novel pain management strategy for uterine fibroid embolization |
title_sort | novel pain management strategy for uterine fibroid embolization |
topic | Uterine fibroid embolization Uterine artery embolization Fibroid Embolization Pain management Nerve block |
url | https://doi.org/10.1186/s42155-025-00516-3 |
work_keys_str_mv | AT elaineho novelpainmanagementstrategyforuterinefibroidembolization AT kiattsongtan novelpainmanagementstrategyforuterinefibroidembolization |