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SIR 2025
Women's Health
Scientific Session
.jpg "Denis Szejnfeld, MD, PhD (he/him/his) photo")
Denis Szejnfeld, MD, PhD (he/him/his)
President
Sobrice - Brazilian society of interventional radiology, Brazil
Priscila Silva, MD
Interventional Radiologist
UNIFESP - Federal University of Sao Paulo, Brazil
Andrea Puchnick, MD, PhD
Teaching and Research Coordinator
UNIFESP - Federal University of Sao Paulo, Brazil
Vinicius Fornazari, MD, PhD
Interventional Radiologist
UNIFESP - Federal University of Sao Paulo, Brazil
Gloria Salazar, MD, FSIR (she/her/hers)
Vice Chair of Development and Engagement
UNC, United States
To compare the effectiveness of the superior hypogastric nerve block (SHNB) to spinal anesthesia in pain control and opioid consumption after uterine artery embolization (UAE).
Materials and Methods:
This is a prospective, experimental and quasi-randomized study including women subjected to UAE. The 42 participants were over 18 years old, presenting symptomatic intramural uterine fibroids. The UAE's usual technique was used. They were divided into two groups as follows: Group 1, subjected to SHNB, and Group 2, subjected to spinal anesthesia. Pain was measured using a visual numerical scale (from 0 to 10) and a face pain scale, applied 1, 6 and 18 hours after the procedure. When there was moderate to intense pain, a standardized morphine dose of 3 mg was applied.
Results:
The groups (21 patients each) were homogeneous regarding all variables studied. The average time taken to conclude the SHNB was 11.67-minutes, and all cases were done with technical success and no complications. The median of pain scores was 2 after 1 and 6 hours, and 3 after 18 hours. Although numerically higher in the SHNB group, the pain scores did not differ significantly between groups. The Spearman correlation identified the size of the largest fibroid as the significant variable for pain in some measurements and analgesia groups. The need for morphine was common in both groups (61.9% patients), whose median was 1 dose per patient, without statistical differences between groups.
Conclusion: SHNB showed efficacy comparable to that of the spinal anesthesia regarding post-procedure pain control and opioid consumption, without statistically significant differences. Therefore, SHNB can be considered a viable, safe, and efficient alternative to reduce pain and the use of opioids in the immediate postoperative of UAE. Moreover, it is a less invasive technique with less associated adverse events than opioids.