Superior Hypogastric Nerve Blockade for Uterine Artery Embolization: A Systematic Review

J Vasc Interv Radiol. 2023 Oct;34(10):1827-1834.e2. doi: 10.1016/j.jvir.2023.06.018. Epub 2023 Jun 19.

Abstract

Superior hypogastric nerve block (SHNB) has potential to reduce pain following uterine artery embolization (UAE). However, existing studies are limited by design, sample size, or conflicting results. A systematic review of the literature was performed. Outcomes included technical success, time to complete SHNB, time under fluoroscopy, procedure time, time to recovery, needle repositioning, same-day discharge, readmission, pain, analgesic consumption, and adverse events. Of 15 included studies, the same-day discharge rate was 98.8%, and readmission rate was 6.9%. The mean pain score was 3.4 in patients who received SHNB compared to 4.3 among controls. Of patients who received SHNB, 46.7% did not require further pain medication. Major adverse events occurred in 0.4% of patients. Early clinical studies suggest that SHNB appears to reduce pain and analgesic consumption in patients undergoing UAE. Additional randomized trials are needed to confirm these findings.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Analgesics
  • Female
  • Humans
  • Leiomyoma* / therapy
  • Nerve Block* / adverse effects
  • Nerve Block* / methods
  • Pain / etiology
  • Treatment Outcome
  • Uterine Artery Embolization* / adverse effects
  • Uterine Artery Embolization* / methods
  • Uterine Neoplasms* / therapy

Substances

  • Analgesics