Evaluation of Uterine Artery Embolisation on Size and Symptomatology of Leiomyoma Under Patient Controlled Analgesia with Meperidine (Pages 14-19)

Merih Bayram1, Erhan Ilgit2, Duygu Altan1, Berrin Gunaydin3, Ahmet Baran Onal2, Koray Akkan2, Ercan Yıldırım3 and Şule Yıldız1

1Gazi University, School of Medicine, Department of Obstetrics and Gynecology (OBGYN), Ankara 06500, Turkey; 2Gazi University, School of Medicine, Department of Interventional Radiology, Ankara 06500, Turkey; 3Gazi University, School of Medicine, Department of Anesthesiology, Ankara 06500, Turkey

DOI: http://dx.doi.org/10.14205/2309-4400.2014.02.01.2

Abstract: Aim: We aimed to present our experience on uterine artery embolization (UAE) under intravenous (iv) patient controlled analgesia (PCA) with meperidine. Methods: Twelve patients, aged between 30 to 45 years with solitary leiomyoma having pelvic pain or heavy menstruel bleeding were included. The size and location of uterine leiomyomas were determined by transvaginal ultrasound. The UAE was performed after angiography of the uterine artery blood supply by percutaneous unilateral common femoral arterial access under iv PCA with meperidine. Both uterine arteries were catheterized with co-axial microcatheter system through this route and embolized between 300 to 900 μm microspheres under fluoroscopic guidance. Results: The fibriod volumes measured after 3 and 6 months significantly decreased when compared to the pre-embolization volumes. Symptoms of irregular excessive menstruel bleeding, pelvic discomfort, bowel and bladder dysfunction, pressure sensation in the lower abdomen and pain during intercourse markedly regressed. Pain relief was provided by iv PCA from the onset of the procedure until 24 hours after the procedure. Conclusion: The UAE procedure under iv PCA with meperidine has been shown to be a comfortable technique that might be offered to patients with symptomatic fibroids in non-reproductive age or desire for not having a child.

Keywords: Interventional radiology, Uterine leiomyoma, embolization, pain relief.