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Pain Levels Within 24 Hours After UFE: A Comparison of Morphine and Fentanyl Patient-Controlled Analgesia

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Abstract

The purpose of this study was to assess the presence and severity of pain levels during 24 h after uterine fibroid embolization (UFE) for symptomatic leiomyomata and compare the effectiveness and adverse effects of morphine patient-controlled analgesia (PCA) versus fentanyl PCA. We carried out a prospective, nonrandomized study of 200 consecutive women who received UFE and morphine or fentanyl PCA after UFE. Pain perception levels were obtained on a 0–10 scale for the 24-h period after UFE. Linear regression methods were used to determine pain trends and differences in pain trends between two groups and the association between pain scores and patient covariates. One hundred eighty-five patients (92.5%) reported greater-than-baseline pain after UFE, and 198 patients (99%) required IV opioid PCA. One hundred thirty-six patients (68.0%) developed nausea during the 24-h period. Seventy-two patients (36%) received morphine PCA and 128 (64%) received fentanyl PCA, without demographic differences. The mean dose of morphine used was 33.8 ± 26.7 mg, while the mean dose of fentanyl was 698.7 ± 537.4 μg. Using this regimen, patients who received morphine PCA had significantly lower pain levels than those who received fentanyl PCA (p < 0.0001). We conclude that patients develop pain requiring IV opioid PCA within 24 h after UFE. Morphine PCA is more effective in reducing post–uterine artery embolization pain than fentanyl PCA. Nausea is a significant adverse effect from opioid PCA.

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Authors and Affiliations

  1. The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA

    Hyun S. Kim & Gregory J. Czuczman

  2. Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA

    Hyun S. Kim & Wanda K. Nicholson

  3. Division of Vascular and Interventional Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins School of Medicine, 600 North Wolfe Street, Blalock 545, Baltimore, MD, 21287-4010, USA

    Hyun S. Kim

  4. Department of Biostatistics, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA

    Luu D. Pham

  5. Department of Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA

    Jeffrey M. Richman

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  1. Hyun S. Kim
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  2. Gregory J. Czuczman
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Correspondence to Hyun S. Kim.

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Kim, H.S., Czuczman, G.J., Nicholson, W.K. et al. Pain Levels Within 24 Hours After UFE: A Comparison of Morphine and Fentanyl Patient-Controlled Analgesia. Cardiovasc Intervent Radiol 31, 1100–1107 (2008). https://doi.org/10.1007/s00270-008-9430-5

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  • DOI: https://doi.org/10.1007/s00270-008-9430-5

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