***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE To investigate whether dexmedetomidine infusion could reduce opioid consumption and opioid-related side effects after uterine artery embolization ( UAE ) . MATERIAL S AND METHODS Fifty patients undergoing UAE for symptomatic leiomyomas or adenomyosis were r and omized into two groups . In 25 patients , dexmedetomidine infusion was started at 0.2 μg/kg/h at 30 minutes before the procedure , followed by 0.4 μg/kg/h for 6 hours after the procedure . In another 25 patients ( control group ) , volume-matched normal saline solution was administered . Both groups received fentanyl-based intravenous patient-controlled analgesia ( PCA ; fentanyl 10 μg/h with a bolus dose of 20 μg ) during the 24 hours after the procedure . Nonspherical polyvinyl alcohol particles were used . Pain scores , fentanyl consumption , need for additional analgesics , and side effects were assessed for 24 hours after UAE . RESULTS Compared with the control group , patients in the dexmedetomidine group required 28 % less PCA fentanyl during the 24 hours after UAE ( P = .006 ) . Numeric rating scale scores for pain ( 5.0±2.4 vs 7.0±2.2 ; P = .026 ) and the need for additional analgesics ( two of 25 vs 17 of 25 ; P<.001 ) were lower in the dexmedetomidine group than in the control group during the first 1 hour after UAE . The incidence and severity of nausea and vomiting during the 24 hours after UAE were lower in the dexmedetomidine group than in the control group ( P < .05 ) . CONCLUSIONS The addition of dexmedetomidine infusion to fentanyl PCA provides better analgesia , fentanyl-sparing effect , and less nausea and vomiting , without significant hemodynamic instability PURPOSE To assess the efficacy of the superior hypogastric nerve block ( SHNB ) in permitting uterine artery embolization ( UAE ) to be performed as a routine outpatient procedure . MATERIAL S AND METHODS One hundred thirty-nine patients who underwent UAE in a prospect i ve single-arm clinical trial in an academic institution underwent  SHNB  from an anterior abdominal approach to control acute postprocedural pain , in addition to conventional conscious sedation . They were discharged and prescribed one of two drug combinations started during the in-hospital recovery period . Regimen A included short-acting morphine tablets and indomethacin rectal suppositories and regimen B included long-acting morphine tablets for baseline pain supplemented with short-acting morphine tablets for breakthrough pain , and naproxen rectal suppositories . All patients were contacted by phone on the third and fifth postprocedural days and their peak pain experience was recorded on a scale of 0 to 10 . RESULTS All patients were able to be discharged the day of the procedure . Seven patients ( 5 % ) returned to the hospital because of pain . One was discharged after undergoing a second SHNB and four were discharged after receiving intravenous analgesics ; two required longer admission for intravenous analgesia . The mean ( + /-SD ) peak pain score in the first 5 days after the procedure for all patients was 4.8 + /- 2.6 . There was a significant difference between regimens A ( mean pain score , 5.7 + /- 2.2 ) and B ( mean pain score , 2.7 + /- 2.5 ; Mann-Whitney , 5.94 ; P < .01 ) . CONCLUSION The addition of SHNB to the more conventional post-UAE pain management methodology enhances pain control , enabling the procedure to be offered with minimum pain on a routine outpatient basis PURPOSE To evaluate whether it is safe to perform uterine artery embolization ( UAE ) as an outpatient procedure . MATERIAL S AND METHODS This retrospective study was approved by the institutional review board and included 234 patients ( age range , 24 - 58 years ; mean age , 40.5 years ) who underwent UAE as an outpatient procedure with polyvinyl alcohol particles between January 2007 and March 2008 . Patients were given acid-suppressing drugs , nonsteroidal anti-inflammatory drugs , anti-histaminic drugs , and laxatives twice on the day before UAE and once on the morning of UAE .  Pain score , rated from 0 to 10 , was evaluated by using a numeric pain scale during UAE , after the procedure , at discharge , at the night of discharge , and on the following morning . The outcome of UAE was evaluated at 6 months by means of pelvic magnetic resonance imaging and clinical observation . RESULTS The mean pain score was 0.9 during embolization , 2.5 4 - 8 hours after embolization , 0.9 at discharge , 1.1 the first night after discharge , and 0.7 the next morning . All patients were discharged from the hospital 4 - 8 hours after the procedure , with no overnight hospital admissions . At 6 months , 146 of 158 patients ( 92.4 % ) reported an improvement in menorrhagia , 39 of 44 ( 88.6 % ) reported an improvement in bulk symptoms , and 20 of 25 ( 80 % ) reported an improvement in pain . The volumes of the uterus and the dominant fibroid decreased 33.7 % and 39.3 % , respectively . CONCLUSIONS With acid-suppressing , anti-inflammatory , and anti-histaminic drugs started on the day before UAE , the procedure can be performed safely as an outpatient procedure The purpose of this study was to assess the presence and severity of pain levels during 24 h after uterine fibroid embolization ( UFE ) for symptomatic leiomyomata and compare the effectiveness and adverse effects of morphine patient-controlled analgesia ( PCA ) versus fentanyl PCA . We carried out a prospect i ve , nonr and omized study of 200 consecutive women who received UFE and morphine or fentanyl PCA after UFE .  Pain perception levels were obtained on a 0–10 scale for the 24-h period after UFE . Linear regression methods were used to determine pain trends and differences in pain trends between two groups and the association between pain scores and patient covariates . One hundred eighty-five patients ( 92.5 % ) reported greater-than-baseline pain after UFE , and 198 patients ( 99 % ) required IV opioid PCA . One hundred thirty-six patients ( 68.0 % ) developed nausea during the 24-h period . Seventy-two patients ( 36 % ) received morphine PCA and 128 ( 64 % ) received fentanyl PCA , without demographic differences . The mean dose of morphine used was 33.8 ± 26.7 mg , while the mean dose of fentanyl was 698.7 ± 537.4 μg . Using this regimen , patients who received morphine PCA had significantly lower pain levels than those who received fentanyl PCA ( p < 0.0001 ) . We conclude that patients develop pain requiring IV opioid PCA within 24 h after UFE . Morphine PCA is more effective in reducing post – uterine artery embolization pain  than fentanyl PCA . Nausea is a significant adverse effect from opioid PCA BACKGROUND Post-procedural pain control after  uterine artery embolization ( UAE ) of urethral leiomyomata remains a major problem . METHODS This double-blind , r and omized 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 . RESULTS NRS 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 . CONCLUSIONS Remifentanil PCA-TCI with a slow and progressive adapted algorithm without any associated premedication or co-medication is feasible in young healthy women undergoing UAE & NA ; Twenty‐six patients with extensive gynecologic , colorectal or genitourinary cancer who suffered uncontrolled , incapacitating pelvic pain were enrolled in this study during a 1‐year period . All the patients receiving oral opioids who developed poor pain response due to the progression of disease or untoward side effects necessitating other modes of therapy were eligible to participate . Bilateral percutaneous neurolytic superior hypogastric plexus blocks with 10 % phenol were performed in every patient , 1 day after receiving successful diagnostic blocks using 0 . 25 % bupivacaine ( BUP ) . All patients reported a visual analog pain score ( VAPS ) of 10 of 10 before the block . Eighteen patients ( 69 % ) had satisfactory pain relief ( VAPS < 4 of 10 ) : 15 ( 57 % ) after 1 block and 3 ( 12 % ) after a second block . The remaining 8 patients ( 31 % ) had moderate pain control ( VAPS 4–7 of 10 ) after 2 blocks and received epidural bupivacaine‐morphine ( BUP‐MS ) therapy with good results . Both groups experienced significant reductions in oral opioid therapy after the neurolytic blocks . No additional blocks were required by patients who had a good response during a follow‐up period of 6 months . No complications related to the block were experienced by any patient . In conclusion , neurolytic superior hypogastric plexus block was both effective in relieving pain in 69 % of the patients studied ( 95 % confidence interval of 48–85 % ) . Additional neurolytic blocks using higher volumes of the neurolytic agent may be needed in patients with extensive retroperitoneal disease , a group in whom moderate or poor results should be expected PURPOSE Uterine artery embolization ( UAE ) is gaining popularity as an alternative to hysterectomy for the treatment of fibroids . Although minimally invasive treatments such as UAE offer the potential of fewer complications , shorter hospital stay , and quicker recovery than surgery , there have been few published data on tolerance and recovery in patients undergoing UAE .  MATERIAL S AND METHODS This was a multicenter prospect i ve single-arm clinical treatment trial involving the practice s of 11 interventional radiologists in eight Ontario university-affiliated and community hospitals . Between November 1998 and November 2000 , 555 women underwent UAE for symptomatic uterine fibroids . Follow-up included ultrasound examinations and telephone interviews . UAE was performed under conscious sedation . Polyvinyl alcohol particles ( 355 - 500 micro m ) were the primary embolic agent , and the procedural endpoint involved stasis in the uterine arteries . Pain protocol s included antiinflammatory medications and narcotics and a planned overnight hospital admission . Tolerance and recovery were measured by patient-reported pain intensity ( 10-point numeric rating and five-point descriptor scale ) , hospital length of stay ( LOS ) , and time until return to work . RESULTS Intraprocedural pain was reported by 30 % of patients and postprocedural pain was reported by 92 % of patients ( mean pain rating + /- SD , 7.0 + /- 2.47 ) . The mean hospital LOS was 1.3 nights . Postprocedural pain was the most common indication for an LOS greater than 1 night ( 18 % ) or 2 nights ( 5 % ) . Return visits to the hospital ( 10 % ) and readmissions ( 3 % ) were primarily for pain . The overall postprocedural complication rate was 8.0 % ( 95 % CI : 5.9%-10.6 % ) . Of the 44 complications , 32 ( 73 % ) were pain-related . The mean recovery time after UAE was 13.1 days ( median , 10.0 d ) . CONCLUSION The majority of patients had a 1-night LOS after UAE and recovered within 2 weeks . Postprocedural pain varied considerably and was the major indication for extended hospital stay and recovery Abstract When compared in a uterine artery embolization ( UAE ) animal model , Embospheres ( ES ) ( Biosphere Medical , Rockl and , MA ) were found to induce less uterine ischemia than polyvinyl alcohol ( PVA ) particles . Given this finding , we aim ed 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 prospect ively acquired data base .  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 
    Output:
    
There is no evidence to suggest that there is any superiority of one protocol above another in the published literature .
Appropriate use of opioids ± NSAIDs ± acetaminophen alone appears to be sufficient to control pain post-UFE .