Preemptive Analgesia Following Uterine Artery Embolization
Status:
Terminated
Trial end date:
2013-10-01
Target enrollment:
Participant gender:
Summary
Uterine leiomyomata, also known as fibroids, are an extremely common benign lesion being
present in 30-50% of all women. Traditional surgical treatment of symptomatic fibroids has
been hysterectomy in post child bearing woman. However, over the last decade, the use of a
minimal invasive technique called uterine artery embolization has become increasingly popular
due to high patient satisfaction, cost effectiveness, and shorter recovery period. The
purpose of this randomized blinded placebo controlled study is to compare pre-emptive
analgesia vs non-preemptive analgesia for immediate postoperative pain control, long term
pain control, and improved quality of life in woman following uterine artery embolization
surgery. The study consists of four drug groups including a placebo group. The addition of
pregabalin and celecoxib together with epidural analgesia may improve pain management as well
as leading to a better post-procedure outcome in women following uterine artery embolization.
Many investigators believe that the ischemia in the normal myometrium is the primary source
of pain immediately following surgery making postoperative pain management challenging.
Epidural fentanyl may offer an advantage when encountering visceral pain. In addition to
being an effective analgesic for chronic pain syndromes, the use of pregabalin provides
effective postoperative analgesia when it is administered pre-emptively before an operation.
Preemptive analgesia involves the introduction of an analgesic regimen before the onset of
noxious stimuli, with the goal of preventing sensitization of the nervous system to
subsequent stimuli that could amplify pain. In human trials, pregabalin has been demonstrated
to reduce pain, improve sleep, and mood disturbances in patients with post herpetic
neuralgia. The use of celecoxib in combination with pregabalin has shown to provide more
effective analgesia by providing antihyperalgesia. Therefore, the addition of pregabalin and
celecoxib together with epidural analgesia may improve pain management as well as having an
effect on long term sequelae.