Erschienen in:
01.08.2003 | Clinical Investigations
Comparison of Pain After Uterine Artery Embolization Using
Tris-Acryl Gelatin Microspheres Versus Polyvinyl Alcohol Particles
verfasst von:
Robert K. Ryu, Reed A. Omary, Michael J. Sichlau, Aheed Siddiqi, Howard B. Chrisman, Albert A. Nemcek Jr., Robert L. Vogelzang
Erschienen in:
CardioVascular and Interventional Radiology
|
Ausgabe 4/2003
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Abstract
When compared in a uterine artery embolization
(UAE) animal model, Embospheres (ES) (Biosphere Medical, Rockland, MA)
were found to induce less uterine ischemia than polyvinyl alcohol (PVA)
particles. Given this finding, we aimed to test the hypothesis that ES
is associated with less pain after UAE than PVA in human patients. We
performed retrospective analysis on data from 72 consecutive UAE
patients, collected from a prospectively acquired database.
Patient-controlled analgesia (PCA) pump-delivered morphine sulfate (MS)
dosages were compared between patients who received ES versus PVA.
Subjective pain scores (SPS) were also compared between the two groups.
Secondary outcome measures, including embolic volume and clinical
outcome data, were also collected. Linear regression and t-test
statistical analyses were performed. Null hypotheses were rejected at
the p < 0.05 level. Mean follow-up period in the PVA
population was 178 days (range 28–426), versus 96 days (range 24–197)
in the ES population. The mean MS doses used by ES and PVA patients
were 37.2 (s.d. 23.5) versus 47.1 (s.d. 26.8), respectively. This
difference was not significant (p > 0.15).
Utilizing a standard 0–10 pain scale, the mean peak SPS for the ES and
PVA groups were 5.58 (s.d. 2.77) and 5.07 (s.d. 2.99), respectively.
The difference was not significant. The mean amount of embolic material
used in each ES and PVA patient was 4.86 cc (s.d. 3.01) and 3.52 cc
(s.d. 1.63), respectively. The difference revealed a strong trend
toward statistical significance (p = 0.05). There was
one treatment failure in each group of patients. Within both patient
samples, no significant correlation was found when comparing the volume
of embolic used and subsequent MS dose. Despite a strong trend toward a
significantly higher volume of ES used per patient, there is no
subjective or objective difference in pain after UAE with ES when
compared to PVA.