Intraarterial lidocaine for pain control after uterine artery embolizationfor leiomyomata

Purpose: To evaluate the effectiveness of intraarterial lidocaine in contro lling pain after uterine artery embolization (UAE). Materials and methods: In this double-blind prospective study, patients und ergoing UAE received preservative-free 1% lidocaine or saline solution (con trol) in the uterine arteries before embolization. Postprocedural pain was managed with patient-controlled intravenous morphine. Attempted doses, numb er of doses received, total morphine dose, and maximum pain numeric rating scale (NRS) score during the postprocedural. hospitalization were recorded and compared. Three-month follow-up magnetic resonance (MR) imaging and sym ptomatic questionnaires were collected and compared. Results: Ten patients received lidocaine and eight patients received placeb o. Moderate to severe vasospasm was noted in seven patients after lidocaine injection, whereas no vasospasm was noted in the placebo group (P=.004). P atients in the lidocaine group had lower NRS pain scores than those in the placebo group (P=.012), whereas there was no difference in morphine require ment between treated patients and control subjects. The study was terminate d after IS patients were treated as a result of unexpected vasospasm. Conclusions: Intraarterial 1% lidocaine is associated with moderate to seve re vasospasm. Lidocaine significantly lowers subjective pain, but there is no difference in analgesic requirements. The routine use of intraarterial l idocaine is not recommended for pain control until the long-term effects of vasospasm on outcome is known.