[Pain control with epidural anesthesia for uterine artery embolization].
BACKGROUND
To reduce the severity of post procedure pain associated with uterine artery embolization (UAE) for leiomyomata, we used continuous infusion of low concentration ropivacaine through an epidural catheter.


METHODS
Thirteen patients for UAE were evaluated. In a patient without indication for epidural anesthesia, the pain was controlled with intermittent morphine infusion. Other patients had post procedure pain managed with 10 ml bolus of 1% lidocaine and continuous infusion of 0.2% ropivacaine at 5 ml x hr-1 for 16 hours.


RESULTS
The patient complained of severe pain just after UAE and required epidural lidocaine. Then, we started to infuse lidocaine or ropivacaine just before starting UAE. Among these cases, 9 patients required extra pain control using NSAIDs as a rescue. Only three patients required no medication except epidural analgesia.


CONCLUSIONS
Continuous infusion of 0.2% ropivacaine at a rate of 5 ml x hr-1 is not enough for pain management after UAE.
Saito
Shigeyuki
S
Department of Anesthesiology, Iwaki Municipal Hospital, Iwaki 973-8555.
Chiba
Ai
A
Hayakawa
Seiichiro
S
Toyoshima
Masafumi
M
Enomoto
Akemi
A
D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D015360:Analgesia, Epidural; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D001158:Arteries; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000628:therapy; D008012:Lidocaine / Q000008:administration & dosage; D008875:Middle Aged; D010149:Postoperative Pain / Q000628:therapy*; D000077212:Ropivacaine; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000628:therapy; D014599:Uterus / Q000098:blood supply*
D000577:Amides; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000077212:Ropivacaine; D008012:Lidocaine