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SIR 2025

Women's Health

Traditional Poster

Session: Traditional Poster Presentations

138 - The Analgesic Efficacy of Intra-arterial Ketorolac in Uterine Artery Embolization

Monday, March 31, 2025
12:10 PM – 1:10 PM CT
Location: Music City Center, Expo Poster Area
Purpose: To evaluate the analgesic efficacy of intra-arterial ketorolac in patients undergoing elective uterine artery embolization (UAE).

Materials and Methods: Retrospective chart review of patients who underwent UAE at a single institution since January 2019. Patients who underwent elective outpatient UAE with or without intrauterine artery administration of ketorolac for symptomatic fibroids, abnormal bleeding, bulk symptoms, pelvic pain, or adenomyosis were included. Patient reported post procedure pain, opioid requirements, length of hospital stay, technical success, and complications were recorded. Statistical analysis was performed using T-tests, Mann Whitney U test, and pairwise analysis where appropriate.

Results: A total of 72 patients underwent elective UAE and were technically successful. Embolization was performed with 500-700 um microspheres. 27 patients (37.5%) received 15 mg of intra-arterial ketorolac after uterine artery stasis. 45 patients (62.5%) did not receive intra-arterial ketorolac. Overall uterine volume was not significantly different between groups (p=0.35). Post-procedural day 0 mean (standard deviation) pain scores were significantly decreased (p< 0.001) in patients who received intra-arterial ketorolac (4.72 +/-2.30) as compared to patients who did not receive intra-arterial ketorolac (6.55 +/-1.82). Pain scores at discharge was also significantly decreased (p=0.011) in patients who received intra-arterial ketorolac (3.96 +/-2.16) as compared to patients who did not (5.38 +/-2.29). Overall hospital mean pain score was significantly decreased in patients who received intra-arterial ketorolac (5.10 +/-1.67) compared to patients who did not (6.39 +/-1.39) with significance (p< 0.001). In-hospital opioid requirement in morphine equivalents was lower with a median of 23.9 (IQR 17.1-36.1) for the intra-arterial ketorolac group as compared to 32.2 (IQR 20.9-41.6) for the no intra-arterial ketorolac group, but not statistically significant (p=0.107).  96.3% of patients in the intra-arterial ketorolac group had a length of stay of one day or less compared with 75.6% of patients in the non-intra-arterial ketorolac group (p=0.025).

Conclusion: In patients undergoing UAE, administration of intra-arterial ketorolac is associated with reduced immediate post procedure pain scores and shorter length of stay.