SynthesisActa cirurgica brasileira2026
Analgesic strategies in the management of postoperative pain following uterine artery embolization for symptomatic fibroids: a systematic review.
Synthesis in Acta cirurgica brasileira, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo identify and compare anesthetic and analgesic strategies employed during uterine artery embolization for symptomatic leiomyomas, assessing their effectiveness in reducing postoperative pain and opioid use and evaluating complication rates.
methodsA systematic review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Searches were performed in PubMed, Embase, Web of Science, and Scientific Electronic Library Online. Randomized controlled trials and prospective cohort or case-control studies, published in the last 10 years, evaluating pain, opioid consumption, and/or complications, were included.
resultsThe total of 3,433 studies were screened, of which six met eligibility criteria. Superior hypogastric plexus block reduced pain and opioid use. Intra-arterial lidocaine decreased pain within 2-4 h and opioid consumption, with a transient effect; administration after vascular stasis was preferable. Controlled-release oxycodone reduced pain at 24 h and need for rescue medication without lowering mean consumption. Dexamethasone reduced pain at 12-24 h without impacting opioid use. No significant complications were reported.
conclusionIn the ischemic phase of post-uterine artery embolization pain, a superior hypogastric nerve block appears to provide the most consistent relief, with intra-arterial lidocaine representing an alternative when resources are limited. For the inflammatory phase, intravenous dexamethasone is the preferred option, whereas controlled-release oxycodone may be considered only in refractory cases.
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