Pelvic pain after uterine artery embolization: a prospective randomized study of polyvinyl alcohol particles mixed with ketoprofen versus bland polyvinyl alcohol particles.
OBJECTIVE
To evaluate whether pelvic pain following uterine artery embolization (UAE) can be decreased by using ketoprofen mixed with polyvinyl alcohol (PVA).


METHODS
A randomized prospective study was performed in 80 patients (age range, 25-52 years; mean age, 41 years) undergoing UAE with PVA between March and August 2006. Forty patients received PVA particles mixed with ketoprofen, and 40 received bland PVA particles. Fifty-three patients who were asymptomatic 8 hours after embolization were discharged. Pain scores were compared during the first 8 hours after the procedure, at discharge, and the following day. The results were evaluated after 6 months.


RESULTS
Eight hours after UAE, 13 of the 40 patients in the group without ketoprofen (32%) reported severe or very severe pain, whereas none of the patients in the group receiving ketoprofen reported severe or very severe pain, as determined with a numeric pain score scale (P = .0015). Nineteen of the 40 patients without ketoprofen (48%) were treated as inpatients, but only 10 in the ketoprofen group (25%) were treated as inpatients. The differences in the clinical outcome, as well in the uterus and fibroid sizes at discharge and at 6 months, were not statistically significant (P > .05).


CONCLUSIONS
The use of PVA particles mixed with ketoprofen resulted in a statistically significant reduction in pelvic pain during the first 8 hours after UAE as compared to the use of PVA alone. However, no significant differences in pain scores were seen after 8 hours. These findings may lead to a reduction in inpatient management for UAE; however, further study of this approach is warranted.
Pisco
João M
JM
St. Louis Hospital and Department of Radiology, Faculty of Medical Sciences, New University of Lisbon. joao.pisco@hpv.min-saude.pt
Bilhim
Tiago
T
Duarte
Marisa
M
Ferreira
Ana
A
Santos
Daniela
D
Pires
F Moura
FM
Oliveira
Antonio G
AG
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D045424:Complex Mixtures / Q000008:administration & dosage; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007660:Ketoprofen / Q000008:administration & dosage*; D008875:Middle Aged; D010147:Pain Measurement / Q000187:drug effects; D010316:Particle Size; D017699:Pelvic Pain / Q000209:etiology* / Q000517:prevention & control*; D011142:Polyvinyl Alcohol / Q000627:therapeutic use*; D055357:Uterine Artery Embolization / Q000009:adverse effects* / Q000379:methods*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D045424:Complex Mixtures; D004338:Drug Combinations; D011142:Polyvinyl Alcohol; D007660:Ketoprofen