Bilateral Paravertebral Block at the T12 as Post–Uterine Fibroid Artery Embolization Analgesia: A Double-blinded Randomized Controlled Clinical Trial

Objective: To investigate the effects of bilateral paravertebral block (PVB) at the T12 on pain and adverse effects after uterine artery embolization (UAE). Design: Prospective, double-blind, and randomized-controlled study. Setting: Second Affiliated Hospital of Soochow University. Population Forty patients undergoing UAE for the treatment of symptomatic fibroids. Methods: Patients scheduled for UAE were randomly assigned to receive either a bilateral PVB at T12 with 20 ml 0.375% ropivacaine or a simulated block. The multimodal analgesia protocol for all patients included systematic administration of flurbiprofen axetil, phloroglucinol, and a sufentanil intravenous patient-controlled analgesia. Main outcome measures The primary outcome was the intravenous cumulative sufentanil consumption within the first 24 h postoperatively. Secondary outcomes included numerical rating scale pain scores at 0, 1, 2, 4, 6 and 24 h postoperatively and so on. Results: Thirty-six patients were analyzed per the established scheme (four patients were dropped because of the discontinuous use of patient-controlled analgesia). The 24-h total sufentanil consumption was statistically lower in the PVB group compared with the control group (30 [25 to 34] versus 40 [34 to 44] μg; median difference, -10; 95%CI, -16 to -6; P < 0.001). The PVB group had a lower maximal numerical rating scale within 24 h postoperatively (3.4 [±1.2] versus 6.1 [±1.9]; mean difference, 2.7; 95% CI, 1.7 to 3.8; P < 0.001). Conclusions: T12 PVB in conjunction with multimodal analgesia provides effective perioperative pain alleviation and reduces the consumption of pain-related opioids after UAE. Funding No funding was obtained for this study.