629 - Intra-Procedural Intra-Arterial Dexamethasone During Uterine Fibroid Embolization

Purpose: To evaluate the impact of intra-arterial dexamethasone administered during uterine fibroid embolization (UFE) on post-procedural opioid use, hospital admission rates, and Emergency Department (ED) or Urgent Care (UC) visits secondary to post-embolization syndrome (PES)-related symptoms.

Materials and Methods: A retrospective review was performed at a single institution of 145 patients who underwent UFE between January 2021 and June 2025. During the study period, patients were typically discharged home after recovery if tolerating oral intake and oral pain medication; otherwise, they were admitted. Patients were categorized into a treatment group (n = 48) that, in addition to routine peri-procedural pain management with intravenous non-steroidal anti-inflammatory drugs, antiemetics, and opioids, received 5 mg intra-arterial dexamethasone followed by 5 mL of 1% lidocaine administered to each uterine artery during embolization, and a control group that did not receive intra-arterial dexamethasone (n = 97). Outcomes included post-procedural hospital admission, opioid use, and return to the ED or UC within 2 weeks for PES-related symptoms. Group comparisons were performed using chi-square or Fisher’s exact testing.

Results: Post-procedural hospital admissions were significantly more frequent in the control group compared with the dexamethasone group (50.5% vs 12.5%, p < 0.001). Rates of post-procedural opioid use were not significantly different between groups (73.2% vs 70.8%, p = 0.80). Two-week ED or UC visits for PES-related symptoms were rare and comparable across groups (6.2% vs 6.3%, p ≈ 1.0).

Conclusion: Intra-arterial dexamethasone administered during UFE was associated with a significant reduction in post-procedural hospital admissions without increasing opioid use or short-term unplanned healthcare utilization. This simple adjunct reduces resource burden and enhances patient care. Prospective validation is warranted.

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