In Reply to: Case 0498_10 --Superior hypogastric nerve block for pain management during fibroid embolization posted by Editor on March 31, 1998 at 14:49:02:
Drs. Pierce and Soulen, I used your technique for superior hypogastric nerve block on 2 patients today. It worked nicely. One patients had no pain at all and the second one had a pain score of 4-5 out of ten. A watch note I may add for users of this technique is that the left iliac vein is in the general area of the needling so caution should be used ( i.e. intermittent aspiration during the Marcaine injection) so that the drug is not inadvertently injected in the vein.
As for your suggestion of injecting boluses of intraarterial lidocaine don't you think that in order to keep lidocaine retained in the uterus it is better to mix it with Ivalon and contrast, rather than injecting it from a separate syringe in between the Ivalon injections. In the latter form the lidocaine is going to escape through the nonobstructed channels into the systemic circulation.