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Postinterventional Patient Comfort After Uterine Artery Embolization and Superior Hypogastric Nerve Block

  • Technical Note
  • Embolisation (arterial)
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Abstract

Purpose

To evaluate the duration and effect of superior hypogastric nerve block (SHNB) with ropivacaine and clonidine on postinterventional pain levels and opioid requirements in patients undergoing uterine artery embolization.

Materials and Methods

Postinterventional pain levels (numeric rating scale, NRS 0–10) and opioid doses were retrospectively analyzed in 53 patients undergoing transfemoral uterine artery embolization and intraprocedural superior hypogastric nerve block during 24 h. A mixture of 150 mg of ropivacaine and 150 µg of clonidine was used for the block.

Results

Postinterventional pain averaged between 1.4 and 2.0 during the first 9 h, after which a small but significant increase was observed (NRS 1.7 ± 1.6 vs. NRS 2.6 ± 2.2, p < 0.001). 70% of patients did not exceed a tolerable pain threshold of NRS 4 during the first 9 h after the intervention. Thirty-three patients (62%) did not require any opioid medication. Mean iv morphine dose was 3.1 ± 4.7 mg, whereas 71% of opioid doses were administered after 9 h.

Conclusion

Superior hypogastric nerve block using a mixture of ropivacaine and clonidine provides good pain relief for 9 h after uterine artery embolization requiring only very low amounts of additional opioids.

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Fig. 1
Fig. 2

Abbreviations

EDA:

Epidural anesthesia

LAST:

Local anesthetic systemic toxicity

NRS:

Numeric rating scale

PCA:

Patient-controlled anesthesia

RPC:

Retained products of conception

SHNB:

Superior hypogastric nerve block

UAE:

Uterine artery embolization

VAS:

Visual analog scale

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Department of Radiology and Nuclear Medicine, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland

    Dominik A. Steffen, Arash Najafi & Christoph A. Binkert

Authors
  1. Dominik A. Steffen
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  2. Arash Najafi
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  3. Christoph A. Binkert
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Corresponding author

Correspondence to Christoph A. Binkert.

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Conflict of interest

DAS has received research support from Philips Healthcare.

Consent for Publication

Consent for publication was obtained for every individual person’s data included in the study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. The study was approved by the local ethics committee (BASEC-ID 2021-02089).

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Informed consent was obtained from all individual participants included in the study.

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Steffen, D.A., Najafi, A. & Binkert, C.A. Postinterventional Patient Comfort After Uterine Artery Embolization and Superior Hypogastric Nerve Block. Cardiovasc Intervent Radiol 46, 152–157 (2023). https://doi.org/10.1007/s00270-022-03290-0

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