Purpose: Anti-emetic medications are commonly used in the post-Uterine Artery Embolization (UAE) period. These drugs include Metoclopramide (Reglan) and Ondansetron (Zofran). We present a prophylactic approach of using transdermal scopolamine (Transderm Scop), which decreases the need for anti-emetic medications post-UAE.
Methods and Materials: Between May, 4th 2001 and June, 7th 2001 20 women underwent UAE with transdermal scopolamine prophylaxis. We compared this group with another group of 20 women treated prior to the institution of scopolamine prophylaxis (between April, 11th 2001 through May, 3rd 2001). We reviewed the patients' charts for medications given to control nausea during their hospitalization.
Results: The two groups were evenly matched by age, race, uterine volume, embolization material, and amount of embolization material used. There was a statistically significant difference between the two groups (p=0.0437; exact test with Savage scores) indicating the use of transdermal scopolamine reduces post-UAE nausea and the use of anti-nausea medications after the procedure. There was no relationship between the amount of PCA narcotics used after UAE and the severity of post-UAE nausea.
Conclusion: The development of nausea after the UAE procedure is a significant problem for many patients and may be due to a number of different causes. Possible causes include inflammation of the uterus with irritation of the adjacent bowel wall serosa, reaction to cell breakdown products in the newly infarcting fibroids or as a side effect of medications (particularly narcotics) given during and after the procedure. The use of transdermal scopolamine as antiemetic prophylaxis decreases the need for anti-emetic medication in the post-procedure period and should be considered as a routine preprocedure medication.
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