Comparison of effectiveness of epidural analgesia and monitored anesthesia care for high-intensity focused ultrasound treatment of adenomyosis

Chang-Soon Lee, Jae Young Lee, Soohan Ro, Seungeun Choi, Jee Youn Moon
International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group · 2018 · vol. 35(1) , pp. 617–625 · doi:10.1080/02656736.2018.1516300 · PMID:30303419 · W2896894091
article OA: hybrid CC0 ⤵ 3 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Epidural analgesia provided superior pain control and ablation efficiency compared to monitored anesthesia care during high-intensity focused ultrasound treatment for adenomyosis, with reduced opioid use.

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Abstract

BACKGROUND: High-intensity focused ultrasound (HIFU) is a noninvasive thermodestructive procedure targeting internal organs with concentrated sonification energy that may cause pain. We aimed to compare the effectiveness of epidural analgesia (EA) and monitored anesthesia care (MAC) in HIFU treatment of uterine adenomyosis. MATERIALS AND METHODS: Sixty-eight patients were included in this case-control study. Thirty-seven patients underwent MAC; 31 patients underwent fluoroscope-guided epidural analgesia. The primary outcome was a frequency of patients reporting severe or very severe intraoperative pain. Secondary outcomes were differences in dosages of analgesics, ablation ratio, and other clinical factors. RESULTS: The EA group reported a significantly lower frequency of severe or very severe intraoperative pain than did the MAC group (41.9% vs. 75.7%; p = .006). Consumption of remifentanil during treatment was significantly lower in the EA group (173 ± 189 µg vs. 426 ± 380 µg; p = .001), as was the use of fentanyl in the recovery room (52 ± 38 µg vs. 75 ± 44 µg; p = .030). Multivariable analysis revealed EA to be the largest contributing factor to increased nonperfused volume ratio (B = 0.41; 95% confidence interval = 0.29 to 0.53; p < .001). The frequency of thermal injury after HIFU was significantly lower in the EA group (22.6% vs. 54.1%; p = .008). CONCLUSIONS: EA during HIFU treatment of uterine adenomyosis improved quality of pain control and ablation ratio over MAC without increasing risk of treatment-related complications. EA also reduced consumption of opioid analgesics during and after HIFU treatment.

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Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Analgesia, Epidural Anesthesia High-Intensity Focused Ultrasound Ablation Adenomyosis Adult Analgesia, Epidural Anesthesia Case-Control Studies Female High-Intensity Focused Ultrasound Ablation Humans Retrospective Studies Young Adult

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europepmc
last seen: 2026-06-04T01:30:01.192114+00:00
openalex
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pubmed
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License: CC0 · commercial use OK