Journal List > J Korean Soc Radiol > v.64(5) > 1086939

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Song, Kang, and Rho: Comparison of an Additional Transdermal Fentanyl Patch Compared to Intravenous NSAID and Opioid Analgesics within 24 Hours of an Uterine Artery Embolization for Myoma and Adenomyosis
Interventional Radiology
Original Article

Journal of the Korean Society of Radiology 2011; 64(5): 449-455.

Published online: 31 May 2011

DOI: https://doi.org/10.3348/jksr.2011.64.5.449

Comparison of an Additional Transdermal Fentanyl Patch Compared to Intravenous NSAID and Opioid Analgesics within 24 Hours of an Uterine Artery Embolization for Myoma and Adenomyosis

Sook Yun Song, M.D.1, Byung Chul Kang, M.D.1, Kyungmin Rho, M.D.1

1Department of Radiology, Mokdong Hospital, Ewha Womans University School of Medicine, Korea.

Address reprint requests to: Byung Chul Kang, M.D., Department of Radiology, Mokdong Hospital, Ewha Womans University School of Medicine, 911-1 Mok-dong, Yangcheon-gu, Seoul 158-710, Korea. Tel. 82-2-2650-5092, Fax. 82-2-2650-5302, kangbc@ewha.ac.kr

Received 23 January 2011       Accepted 11 April 2011

Copyright © 2011 The Korean Society of Radiology

Abstract

Purpose

To evaluate the effectiveness of an additional transdermal fentanyl patch compared to intravenous analgesics in pain control during the 24-hour period following uterine artery embolization (UAE) for myoma and adenomyosis.

Materials and Methods

Between September 2009 and August 2010, 42 patients underwent UAE for myoma or adenomyosis. Of these, 21 received an intravenous opioid (pethidine) and a nonsteroidal anti-inflammatory drug (group A), and 21 received an additional transdermal fentanyl patch (group B). Pain perception levels were established verbally on a 0-10 scale during the 24-hour period following UAE. Differences in pain trends, mean dose of intravenous pethidine, and adverse effects were compared between the two groups.

Results

Pain perception was most severe at 6 hours after UAE and the mean pain level of group B at that time was 6.3 ± 0.7, which was significantly lower than that of group A, 8.2 ± 0.7 (p<0.05). The mean dose of intravenous pethidine was 114.3 ± 59.5 mg in group A and 90.5 ± 49.0 mg in group B, while the incidence of nausea was 67% in group A and 77% in group B. In both cases, the differences were not significantly different (p>0.05), and no evidence of respiratory distress was demonstrated.

Conclusion

The addition of a transdermal fentanyl patch to intravenous analgesics is effective in reducing post-embolization pain during the 24-hour period after UAE.

Keywords: Uterine Artery Embolization, Fentanyl, Transdermal Patch

Figures and Tables

Fig. 1

Successful uterine artery embolization in a 44-year-old patient with symptomatic adenomyosis.

A, B. Sagittal T2-weighted image (A) and fat suppressed gadolinium enhanced T1-weighted image (B) show the enlarged uterus with hyperintense foci in myometrium and intense contrast enhancement, suggestive of adenomyosis.
C. Follow-up sagittal fat suppressed gadolinium enhanced T1-weighted image four months after embolization shows near-complete infarction of adenomyosis in the uterine fundus with decreased volume.
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Fig. 2

Mean pain level by verbal rating scale during 24 hours after uterine artery embolization.

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Fig. 3

Difference of mean pain level between two groups by verbal rating scale during 24 hours after uterine artery embolization.

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Table 1

Characteristics of Patients

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Note.─ * Data are means ± standard deviations.

† Calculated with the Mann-Whitney U test.

† Calculated with the Chi-square test.

Table 2

Mean Pain Level by Verbal Rating Scale during 24 Hours after Uterine Artery Embolization

jksr-64-449-i002

Note.─ * Data are means ± standard deviations.

† Calculated with the Mann-Whitney U test.

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