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12 - Pain management during and after uterine artery embolization

Published online by Cambridge University Press:  10 November 2010

Suresh Vedantham
Affiliation:
Washington University in St. Louis, Missouri, USA
Scott C. Goodwin
Affiliation:
Veteran Administration, UCLA Medical Center, California, USA
Togas Tulandi
Affiliation:
McGill University, Montréal
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Summary

Introduction

Uterine artery embolization (UAE) has evolved into a safe and effective alternative treatment for women with symptomatic uterine fibroids. Published series have documented clinical response rates of 81–94% for menorrhagia and 64–96% for bulk-related symptoms, with high patient satisfaction ratings and few major complications. The advantages of this procedure include shorter hospitalizations, uterine preservation, and the ability to treat all myomata in the uterus in a single session. Importantly, the nonsurgical nature of UAE enables the procefure to be performed under conscious sedation, a very important advantage that significantly lowers the risks and morbidity of the procedure.

Many critical aspects of establishing a UAE program relate to ensuring the tolerability of the procedure. Careful attention to compassionate periprocedural patient care is paramount in encouraging physicians to continue recommending this treatment option to their patients. With the UAE patient population, many referrals reach the interventionalist through word-of-mouth patient-to-patient referral; the practitioner who does not expend maximum effort ensuring patient comfort will very rightly not receive such referrals. The interventional physician must be able to provide the patient with reasonable expectations about the peri-procedural discomfort she might encounter, establish a routine monitoring and sedation plan for UAE, ensure a suitable environment for post-procedure patient recovery, prevent and treat post-procedural symptoms, communicate with the patient and nursing staff, and monitor patient satisfaction.

Type
Chapter
Information
Uterine Fibroids
Embolization and other Treatments
, pp. 91 - 96
Publisher: Cambridge University Press
Print publication year: 2003

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