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.