{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:06:15Z","timestamp":1789574775735,"version":"build-2803163510"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T00:00:00Z","timestamp":1737504000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T00:00:00Z","timestamp":1737504000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["CVIR Endovasc"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Uterine fibroid embolization can be associated with significant pain due to fibroid ischemia and interventions of the procedure itself. Fentanyl and midazolam are commonly provided for sedation and pain relief, but are not tolerated by all patients. This report outlines a novel pain management strategy for uterine fibroid embolization in a patient who could not receive either opioids or benzodiazepines.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A 51\u00a0year old woman presenting with menorrhagia due to uterine fibroids was referred to interventional radiology for embolization. She was allergic to most opiates and had previously become agitated with IV midazolam, resulting in termination of a previous attempt at embolization. Thus, a combination of three analgesic modalities was used: intraarterial ropivacaine in the uterine arteries, superior hypogastric nerve block with ropivacaine, and intravenous acetaminophen. The patient underwent successful embolization and reported only intermittent pain of 1\u20132 out of 10 intensity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Discussion<\/jats:title>\n            <jats:p>This combined analgesic cocktail represents a novel alternative to traditional sedation for uterine fibroid embolization and may serve as a viable option for patients with similar contraindications.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s42155-025-00516-3","type":"journal-article","created":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T08:55:59Z","timestamp":1737536159000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Novel pain management strategy for uterine fibroid embolization"],"prefix":"10.1186","volume":"8","author":[{"given":"Elaine","family":"Ho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5310-3458","authenticated-orcid":false,"given":"Kiat Tsong","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,22]]},"reference":[{"key":"516_CR1","volume-title":"Uterine Fibroid Embolization","author":"M Young","year":"2024","unstructured":"Young M, Coffey W, Mikhail LN. Uterine Fibroid Embolization. StatPearls, Treasure Island (FL): StatPearls Publishing; 2024."},{"key":"516_CR2","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1055\/s-0041-1739161","volume":"38","author":"JL du Pisanie","year":"2021","unstructured":"du Pisanie JL, Commander CW, Burke CT. Management of Postprocedural Uterine Artery Embolization Pain. Semin Interv Radiol. 2021;38:588\u201394. https:\/\/doi.org\/10.1055\/s-0041-1739161.","journal-title":"Semin Interv Radiol"},{"key":"516_CR3","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1177\/0846537119888391","volume":"71","author":"PJ Park","year":"2020","unstructured":"Park PJ, Kokabi N, Nadendla P, Lindsey T, Dariushnia SR. Efficacy of Intraprocedural Superior Hypogastric Nerve Block in Reduction of Postuterine Artery Embolization Narcotic Analgesia Use. Can Assoc Radiol J J Assoc Can Radiol. 2020;71:75\u201380. https:\/\/doi.org\/10.1177\/0846537119888391.","journal-title":"Can Assoc Radiol J J Assoc Can Radiol"},{"key":"516_CR4","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1053\/trap.2001.23679","volume":"5","author":"L Groban","year":"2001","unstructured":"Groban L, Dolinski SY. Differences in cardiac toxicity among ropivacaine, levobupivacaine, bupivacaine, and lidocaine. Tech Reg Anesth Pain Manag. 2001;5:48\u201355. https:\/\/doi.org\/10.1053\/trap.2001.23679.","journal-title":"Tech Reg Anesth Pain Manag"},{"key":"516_CR5","unstructured":"Product monograph \u2013 ropivacaine hydrochloride, USP [Internet]. Toronto (ON): Fresenius Kabi Canada Ltd.; 2018 Oct 29 [cited 2024 Dec 20]. Available from: https:\/\/pdf.hres.ca\/dpd_pm\/00048075.PDF."},{"key":"516_CR6","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.jvir.2016.10.001","volume":"28","author":"M Noel-Lamy","year":"2017","unstructured":"Noel-Lamy M, Tan KT, Simons ME, Sniderman KW, Mironov O, Rajan DK. Intraarterial Lidocaine for Pain Control in Uterine Artery Embolization: A Prospective, Randomized Study. J Vasc Interv Radiol JVIR. 2017;28:16\u201322. https:\/\/doi.org\/10.1016\/j.jvir.2016.10.001.","journal-title":"J Vasc Interv Radiol JVIR"},{"key":"516_CR7","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.jvir.2010.09.018","volume":"22","author":"T Bilhim","year":"2011","unstructured":"Bilhim T, Pisco JM, Duarte M, Oliveira AG. Polyvinyl alcohol particle size for uterine artery embolization: a prospective randomized study of initial use of 350\u2013500 \u03bcm particles versus initial use of 500\u2013700 \u03bcm particles. J Vasc Interv Radiol JVIR. 2011;22:21\u20137. https:\/\/doi.org\/10.1016\/j.jvir.2010.09.018.","journal-title":"J Vasc Interv Radiol JVIR"},{"key":"516_CR8","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1055\/a-1231-5649","volume":"193","author":"A Malouhi","year":"2021","unstructured":"Malouhi A, Aschenbach R, Erbe A, Owsianowski Z, Ru\u00dfwurm S, Runnebaum IB, et al. Effectiveness of Superior Hypogastric Plexus Block for Pain Control Compared to Epidural Anesthesia in Women Requiring Uterine Artery Embolization for the Treatment of Uterine Fibroids - A Retrospective Evaluation. ROFO Fortschr Geb Rontgenstr Nuklearmed. 2021;193:289\u201397. https:\/\/doi.org\/10.1055\/a-1231-5649.","journal-title":"ROFO Fortschr Geb Rontgenstr Nuklearmed"}],"container-title":["CVIR Endovascular"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42155-025-00516-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s42155-025-00516-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42155-025-00516-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T08:56:01Z","timestamp":1737536161000},"score":1,"resource":{"primary":{"URL":"https:\/\/CVIRendovasc.springeropen.com\/articles\/10.1186\/s42155-025-00516-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,22]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["516"],"URL":"https:\/\/doi.org\/10.1186\/s42155-025-00516-3","relation":{},"ISSN":["2520-8934"],"issn-type":[{"value":"2520-8934","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,22]]},"assertion":[{"value":"5 August 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 January 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent was obtained from the patient discussed in this case report. The institutional review board (McMaster Research Ethics Board) does not require approval for this type of research (case report). This research was carried out in accordance with The Code of Ethics of the World Medical Association (Declaration of Helsinki).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"8"}}