Intraarterial Dexamethasone Improves Pain Control After Uterine Fibroid Embolization: JAMA

A new study published in the Journal of American Medical Association showed that during uterine fibroid embolization (UFE), postprocedural discomfort was considerably decreased by injecting dexamethasone directly into the uterine arteries, when compared to placebo.

A minimally invasive technique called uterine fibroid embolization is used to treat symptomatic uterine fibroids by cutting off their blood supply, which causes them to shrink. However, because the fibroid tissue becomes ischemic during the operation, transient pelvic discomfort is rather typical. Even though a number of drugs are used to manage chronic pain, it is still difficult to minimize opiate use while still providing adequate comfort. Therefore, this study was set to ascertain if postprocedural discomfort might be decreased by injecting dexamethasone directly into the uterine arteries during UFE.

Women receiving UFE for symptomatic uterine fibroids participated in this clinical research. During the embolization process, the participants were randomized to receive either intraarterial dexamethasone or a placebo. In addition to assessing opioid needs and treatment-related side events, this study used a numerical rating scale to measure pain during the first 24 hours following UFE. Thus, this experiment was to ascertain whether administering the corticosteroid directly to the arteries undergoing treatment may offer more pain alleviation than conventional postprocedural care.

After eliminating two individuals, 40 of the 42 women randomized were included in the final analysis. In the dexamethasone group, 7 individuals (35%) were African American, 6 (30%) were Hispanic, and 7 (35%) were White. In the placebo group, 9 (45%) were African American, 8 (40%) were Hispanic, and 3 (15%) were White. When compared to placebo, intraarterial dexamethasone resulted in significantly lower mean (SD) pain scores immediately after the procedure and through 96 hours.

Over 168 hours, the dexamethasone group had a substantially reduced mean (SE) pain score compared to the placebo group. The dexamethasone group experienced a mean (SD) uterine volume reduction of 37.4% (17.7%) from baseline to 3 months, compared to 29.6% (20.2%) in the placebo group (P = .30), while the dominant fibroid volume reduction was 34.4% (22.8%) vs 38.6% (16.7%) (P = .60).

Overall, intraarterial dexamethasone used during uterine fibroid embolization appears to provide good early pain alleviation and may lessen the need for opioid drugs following the treatment. Because UFE is increasingly being utilized as a less invasive alternative to surgery for symptomatic fibroids, enhancing recovery and patient comfort may make the technique more appealing.

Reference:

Briley, K., Jr, Reddy, R., Cavada, A., Alessandrino, F., Zarnegarnia, Y., Carugno, J., Miller, Z., Venkat, S., Allakhverdieva, E. A., & Mohan, P. (2026). Intraarterial dexamethasone for pain relief after uterine fibroid embolization: A randomized clinical trial: A randomized clinical trial. JAMA Network Open, 9(7), e2625004. https://doi.org/10.1001/jamanetworkopen.2026.25004