Superior Hypogastric Nerve Block for Pain Control in Outpatient Uterine Artery Embolization

Rasuli, Pasteur; Jolly, Elaine; Hammond, Ian; French, Gordon J.; Preston, Roanne; Goulet, Sally; Hamilton, Linda H.; Tabib, Mohamed

doi:10.1097/01.rvi.0000137406.09852.a4

Cited by 45 publications

(31 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients are sent home with oral analgesia such as tramadol and diclofenac. Recent evidence suggests that superior hypogastric nerve block may be effective in an outpatient setting 39 . The role of prophylactic antibiotics and pretreatment screening for infection has not yet been established.…”

Section: Introductionmentioning

confidence: 99%

What is the place of uterine artery embolisation in the management of symptomatic uterine fibroids?

Hickey

Hammond

2008

Aust NZ J Obst Gynaeco

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

What is the place of uterine artery embolisation in the management of symptomatic uterine fibroids?

Hickey

Hammond

2008

Aust NZ J Obst Gynaeco

Self Cite

View full text Add to dashboard Cite

show abstract

“…The mean peak pain score in the first 5 days in patients in group A was 4.8 (AE 2.6), while the peak pain score for patients in group B was only 2.7 (AE 2.5). 26 Similarly, the authors have found that the combination of SHNB and anti-inflammatories have significantly reduced the need for narcotics and, therefore, the associated side effects after UAE.…”

Section: Intraprocedural Pain Control Measuresmentioning

confidence: 93%

Clinical and Periprocedural Pain Management for Uterine Artery Embolization

Spencer¹,

Stratil²,

Mizones³

2013

Semin intervent Radiol

View full text Add to dashboard Cite

Uterine artery embolization has Level A data supporting excellent safety and efficacy in treating symptomatic uterine leiomyomata. However, there is a perception that either postprocedural pain is severe or poorly managed by the physician performing these procedures. This has led some primary care physicians to omit this procedure from the patients' options or to steer patients away from this procedure. A few simple techniques (pruning of the vascular tree and embolizing to 5?10 beat stasis) and fastidious pre-, intra-, and post-procedural management can nearly eliminate significant pain associated with embolization. Specifically, early implementation of long-acting low-dose narcotics, antiemetics and anti-inflammatory medications is critical. Finally, the use of a superior hypogastric nerve block, which takes minutes to perform and carries a very low risk, significantly reduces pain and diminishes the need for narcotics; when this technique was used in a prospective study, all patients were able to be discharged the day of the procedure. In the authors' experience, patients treated in this manner largely recover completely within 5 days and have a far less traumatic experience than patients traditionally treated with only midazolam (Versed) and fentanyl citrate (fentanyl) intraprocedurally, and narcotics and nonsteroidal antiinflammatory drugs postprocedurally.

show abstract

“…Forty-seven out of 49 (96%) patients were treated as outpatients with good pain control 6 to 8 hours after UAE. Rasuli et al [7] used superior hypogastric nerve block (SHNB) in addition to morphine tablets and indomethacin or naproxen rectal suppositories and proved that this protocol achieved good pain control, enabling the procedure to be performed on an outpatient basis with minimum pain. Before discharge, each patient’s pain level was recorded on a simple four-point descriptive scale (no pain, mild, moderate, and severe pain) by a nurse.…”

Section: Different Medication Protocols To Treat Pain After Uaementioning

confidence: 99%

The Role of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) in the Management of the Post-Embolization Symptoms after Uterine Artery Embolization

Bilhim

Pisco

2010

Pharmaceuticals

View full text Add to dashboard Cite

Uterine artery embolization (UAE) is usually a very painful procedure. Although pain after the procedure can occur as a single symptom, it usually is associated with other symptoms such as nausea, vomiting, pelvic pain, general malaise, fever and leukocytosis that characterize the post-embolization syndrome. Management of the post-embolization symptoms and of pain in particular, is paramount if UAE is to be performed as an outpatient procedure. Different protocols have used analgesic and/or anti-inflammatory agents to control these symptoms. Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used in association with analgesic drugs to control post-embolization symptoms. In our institution the patients start oral medication with NSAIDs the day before the procedure and continue it during and after UAE. We also mix NSAIDs with the embolizing particles. This enables a reduction in the inflammation present in the uterine fibroids and helps controlling the pain. The purpose of this paper is to review the importance of NSAIDs in the management of the post-embolization symptoms. We describe the protocol that we use in our institution that enables us to perform the procedure on an outpatient basis with same day discharge and good control of the post-embolization symptoms with oral NSAIDs and analgesics.

show abstract

Superior Hypogastric Nerve Block for Pain Control in Outpatient Uterine Artery Embolization

Cited by 45 publications

References 20 publications

What is the place of uterine artery embolisation in the management of symptomatic uterine fibroids?

What is the place of uterine artery embolisation in the management of symptomatic uterine fibroids?

Clinical and Periprocedural Pain Management for Uterine Artery Embolization

The Role of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) in the Management of the Post-Embolization Symptoms after Uterine Artery Embolization

Contact Info

Product

Resources

About