"We strongly believe that the best pain relief possible during UAE is :

• An Epidural followed by an injection of morphine (Duramorph) into the catheter toward the end of the procedure which continues very significant pain relief (though not the epidural) for 12-24 hours longer.
• Intravenous sedation and other medications injected into the uterine arteries (during the procedure).
  
  If only sedation is used, as some centers prefer, it does not offer - in our experience - adequate pain management.

How to estimate "Degree of Pain" for puposes of comparison

Figuring out the "amount" of pain any procedure causes is not easy. It various somewhat from patient to patient, and there are no instruments yet devised to take measurements. As a result, physicians involved in "Pain Management" have devised a rough scale to quantify "amount of pain" as best possible. The determination is a subjective one on the part of the patient, but at least gives the patient and her physicians some grounds to answer the question you asked.

A Pain Scale

The commonly used scale is from 0 to 10, where 0 is - of course - NO PAIN, and 10 is INTENSE PAIN. Patients are asked to pick a number between them, to describe how uncomfortable they are. Though this is not perfect, it does provide some way to compare pain, and estimate how well it is being managed.

Several Comparisons with common procedures

To be specific, the nurses in our PostOperative Recovery Unit report that most patients emerging after an abdominal operation (such as a hysterectomy or myomectomy) report pain in the upper range, perhaps 8 or 10 until pain medication catches up.

We reported our experience of the first 24 UAE patients we embolized using the anesthesia routine noted above. Since that time we have done over 100 cases with results we believe to be similar.

Pain Measurement in our Unit after UAE

Our study reported the following figures as Post UAE average pain score for fibroid patients in our institution:

1. Immediately after the procedure = 1.5
2. The night after the procedure = 2.3
3. The next morning = 2. 3
4. One week post procedure = 1.3

This is not representative of patients whose pain management is only sedation during the procedure.

The results in our institution have been encouraging. All patients are discharged within 23 hours. Pain is minimal and most patients have returned to work without medication within a week (the average of 7 days, range 4-14 days)."

Dr Forcade, 9/99