Vascular Interventional Radiology, Medical Imaging Department, Ministry of National Guard Health Affairs, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Acta Radiol. 2024 Mar;65(3):302-306. doi: 10.1177/02841851221146517. Epub 2023 Jan 4.
There have been conflicting outcomes regarding the use of lidocaine to reduce pain after uterine artery embolization (UAE).
To investigate the efficacy of intra-arterial lidocaine injection for pain and inflammatory response control within 24 h of UAE for symptomatic uterine fibroids.
Of 1530 patients who underwent UAE for uterine fibroids in 2007-2021, 5 mL of 1% lidocaine was injected into each uterine artery immediately after UAE in 23 patients. A disease-matched control group (n = 23) who did not receive intra-arterial lidocaine was generated from the same registry. The pain score, white blood cell (WBC) count, C-reactive protein (CRP), neutrophil/lymphocyte ratio (NLR), and fentanyl consumption were compared before and after UAE. Complete infarction of the dominant fibroid was assessed using magnetic resonance imaging.
Significantly lower WBC count, CRP level, and NLR were noted 24 h after UAE in the lidocaine group. No statistically significant difference was noted in the pain score between groups at 0-24 h. The cumulative fentanyl dose administered during the first 24 h after UAE was not significantly different. After embolization, fibroid-related symptoms resolved in all patients. No significant difference was observed in the rate of complete infarction of the dominant fibroid.
Lidocaine administration immediately after UAE resulted in a significant reduction in the inflammatory response. However, such a difference in the inflammatory reaction did not contribute to significant reductions in pain scores or fentanyl consumption.
关于在子宫动脉栓塞术（UAE）后使用利多卡因减轻疼痛，结果存在冲突。
研究在 2007 年至 2021 年间接受 UAE 治疗症状性子宫肌瘤的 1530 例患者中，23 例患者在 UAE 后立即向每个子宫动脉内注射 5mL 1%利多卡因，以探讨其在控制 UAE 后 24 小时内疼痛和炎症反应的疗效。从同一登记处生成了一个未接受动脉内利多卡因注射的疾病匹配对照组（n=23）。比较 UAE 前后的疼痛评分、白细胞（WBC）计数、C 反应蛋白（CRP）、中性粒细胞/淋巴细胞比值（NLR）和芬太尼消耗量。使用磁共振成像评估主导肌瘤的完全梗死情况。
利多卡因组 UAE 后 24 小时 WBC 计数、CRP 水平和 NLR 显著降低。两组在 0-24 小时的疼痛评分无统计学差异。UAE 后 24 小时内给予的芬太尼累积剂量无显著差异。栓塞后，所有患者的肌瘤相关症状均得到缓解。主导肌瘤完全梗死的发生率无显著差异。
UAE 后立即给予利多卡因可显著减轻炎症反应。然而，这种炎症反应的差异并没有导致疼痛评分或芬太尼消耗的显著降低。
