{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T10:01:58Z","timestamp":1789984918358,"version":"4.0.1"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Uterine artery embolization (UAE) is an effective minimally invasive treatment for symptomatic fibroids; however, post\u2010procedural pain remains a major limitation. Intra\u2010arterial lidocaine administration has shown inconsistent results with concerns regarding vasospasm and incomplete embolization. We addressed this by introducing a sequenced protocol utilizing prophylactic intra\u2010arterial nitroglycerin. This study aimed to characterize post\u2010procedural pain trajectories, identify predictors of pain severity, and evaluate the safety of the regimen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective single\u2010arm study, 34 women with symptomatic uterine fibroids underwent UAE between April and August 2025. To prevent vasospasm, 100\u2009\u00b5g of intra\u2010arterial nitroglycerin was administered into each uterine artery before embolization. Embolization was then performed to near\u2010stasis, after which 2\u2009mL of 1% lidocaine (20\u2009mg per uterine artery) diluted to 4\u2009mL was infused intra\u2010arterially. Pain intensity was recorded using the Visual Analog Scale (VAS) at baseline and at 1, 2, 3, 6, 12, and 24\u2009h post\u2010procedure. Associations between fibroid characteristics and pain were analyzed using correlation analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All procedures were technically successful without complications or vasospasm. The mean patient VAS score peaked at 3\u2009h (6.24\u2009\u00b1\u20091.67) and gradually declined thereafter. The volume of the largest fibroid correlated positively with mean pain (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u20090.51 [95% CI: 0.10\u20130.77],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) and with pain at 1 and 2\u2009h (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05). No significant associations were found between pain and uterine size, parity, or adenomyosis. The low\u2010dose intra\u2010arterial lidocaine regimen was well tolerated and did not affect embolization outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The volume of the largest uterine fibroid was associated with greater post\u2010UAE pain. Prophylactic intra\u2010arterial nitroglycerin administered before embolization allowed subsequent intra\u2010arterial lidocaine administration without observed vasospasm. Larger randomized trials are needed to further evaluate and optimize this analgesic approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.72572","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T03:34:50Z","timestamp":1780976090000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pain Trajectories and Predictors Following Uterine Artery Embolization Using a Nitroglycerin\u2013Lidocaine Protocol: A Prospective Study"],"prefix":"10.1002","volume":"9","author":[{"given":"Fatemeh","family":"Mahdavi Sabet","sequence":"first","affiliation":[{"name":"School of Medicine, Tehran Medical Sciences Branch Islamic Azad University Tehran Iran"},{"name":"Advanced Diagnostic and Interventional Radiology Research Center (ADIR) Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamed","family":"Ghorani","sequence":"additional","affiliation":[{"name":"Advanced Diagnostic and Interventional Radiology Research Center (ADIR) Tehran University of Medical Sciences Tehran Iran"},{"name":"Department of Radiology, Shariati Hospital Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3666-0476","authenticated-orcid":false,"given":"Ali","family":"Mahdavi","sequence":"additional","affiliation":[{"name":"Department of Radiology, Imam Hossein Hospital Shahid Beheshti University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-69754-0"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fgwh.2025.1601341"},{"key":"e_1_2_14_4_1","first-page":"1754","article-title":"[Arterial Embolization: A New Treatment of Menorrhagia in Uterine Fibroma]","volume":"24","author":"Ravina J. 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