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, Byung Chul Kang, Kyungmin Rho
In: Journal of the Korean Society of Radiology · 2011 · vol. 64(5) , pp. 449 · doi:10.3348/jksr.2011.64.5.449 · W2291418890
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-08 ⓘ

An additional transdermal fentanyl patch reduced pain perception 6 hours after uterine artery embolization for myoma and adenomyosis compared to IV NSAIDs and opioids.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 · read from full text ⓘ

This study evaluated whether adding a transdermal fentanyl patch improved pain control during the first 24 hours after uterine artery embolization (UAE) in 42 patients treated for myoma or adenomyosis, comparing outcomes to intravenous pethidine plus an NSAID. Pain was scored on a 0–10 verbal rating scale at multiple time points, with comparison of pain trends, mean pethidine dose, and adverse effects between two groups of 21. Pain was most severe at 6 hours post-UAE, and the mean pain score in the transdermal fentanyl group was lower than in the intravenous analgesic group (6.3 ± 0.7 vs 8.2 ± 0.7; p<0.05), with similar (not statistically different) pethidine dosing and nausea incidence, and no respiratory distress observed. This paper is centrally about endometriosis—adenomyosis, specifically focusing on post-UAE analgesic effectiveness in patients with adenomyosis.

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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. Fig. 1 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. 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. Fig. 2 Mean pain level by verbal rating scale during 24 hours after uterine artery embolization. Fig. 3 Difference of mean pain level between two groups by verbal rating scale during 24 hours after uterine artery embolization. Table 1 Characteristics of Patients Table 2 Mean Pain Level by Verbal Rating Scale during 24 Hours after Uterine Artery Embolization

References

- Lohle PN, De Vries J, Klazen CA, Boekkooi PF, Vervest HA, Smeets AJ, et al. Uterine artery embolization for symptomatic adenomyosis with or without uterine leiomyomas with the use of calibrated tris-acryl gelatin microspheres: midterm clinical and MR imaging follow-up. J Vasc Interv Radiol 2007;18:835–841. - - Siskin GP, Shlansky-Goldberg RD, Goodwin SC, Sterling K, Lipman JC, Nosher JL, et al. A prospective multicenter comparative study between myomectomy and uterine artery embolization with polyvinyl alcohol microspheres: long-term clinical outcomes in patients with symptomatic uterine fibroids. J Vasc Interv Radiol 2006;17:1287–1295. - - Nagao T, Ohwada T, Kitazono M, Ohshima K, Shimizu H, Katayama M. Thoracic epidural analgesia is effective in perioperative pain relief for uterine artery embolization. Masui 2005;54:156–159. - - Strupp C, Sudhoff T, Germing U, Hunerliturkoglu A, Schneider P, Niederste-Hollenberg A, et al. Transdermal fentanyl during high-dose chemotherapy and autologous stem cell support. Oncol Rep 2000;7:659–661. - - Mantovani G, Curreli L, Maccio A, Massa E, Massa D, Mulas C, et al. Prevention of nausea and vomiting (N&V) in cancer patients receiving high-dose cisplatin. assessment of the potential antiemetic activity of transdermal fentanyl (TTS-F) compared to standard antiemetic treatment in acute and delayed N&V: first clinical report. Anticancer Res 1999;19:3495–3502. -

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