[Thoracic epidural analgesia is effective in perioperative pain relief for uterine artery embolization].
BACKGROUND
Uterine artery embolization (UAE) has become widely employed in Japan. Although several methods of anesthesia and analgesia are performed for UAE, pain control does not appear to be satisfactory. We report a series of UAE, successfully managed using thoracic epidural analgesia.


METHODS
Before UAE an epidural analgesic catheter was inserted at T 10-11. Local anesthetic and morphine sulfate were administered through the catheter. After the UAE patients received patient-controlled epidural analgesia (PCEA) for 24 hours. The next day, patients were treated with diclofenac sodium 25 mg suppository every 8 hours.


RESULTS
In all cases, early pain was controlled well by epidural analgesia. Late pain was controlled by combining epidural analgesia with diclofenac sodium. Nausea and pruritus due to morphine sulfate occurred in some cases, but disappeared after discontinuation of PCEA.


CONCLUSIONS
Several phases of severe pain are seen perioperatively in UAE. Because thoracic epidural analgesia is easily administered and the dosage of the drugs used effectively controlled, it is a practical method for perioperative pain control for UAE.
Nagao
Tomoya
T
Department of Anesthesia, St. Luke's International Hospital, Tokyo 104-8560.
Ohwada
Tetsuro
T
Kitazono
Miho
M
Ohshima
Kousei
K
Shimizu
Hiroshi
H
Katayama
Masao
M
D000328:Adult; D015360:Analgesia, Epidural; D016058:Analgesia, Patient-Controlled; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D004008:Diclofenac / Q000627:therapeutic use; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000628:therapy*; D008875:Middle Aged; D014594:Uterine Neoplasms / Q000628:therapy*; D014599:Uterus / Q000098:blood supply
D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac