• M Lipszyc, E Winters, E Engelman, M Baurain, and L Barvais.
• Department of Anaesthesia, Institut Jules Bordet, Boulevard de Waterloo 121, 1000 Brussels, Belgium.
• Br J Anaesth. 2011 May 1;106(5):724-31.

BackgroundPost-procedural pain control after uterine artery embolization (UAE) of urethral leiomyomata remains a major problem.MethodsThis double-blind, randomized study tested the possibility to obtain a quicker onset of analgesia by using effect-compartment controlled remifentanil patient-controlled analgesia (remifentanil TCI-PCA) than by using i.v. morphine PCA. Both systems were connected to an i.v. catheter. Active drug or matching placebo administration was activated by a single push-button. Pain was assessed using a numerical rating scale (NRS) from 0 to 10.ResultsNRS values were lower in the remifentanil group (with a possible difference from two to seven points on the scale) during the initial 4 h post-embolization. After the fourth hour, the NRS values were identical between the groups. No major respiratory or haemodynamic side-effect was observed.ConclusionsRemifentanil PCA-TCI with a slow and progressive adapted algorithm without any associated premedication or co-medication is feasible in young healthy women undergoing UAE.

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