Intra-arterial lidocaine as a pain management strategy for uterine artery embolisation: a systematic review and meta-analysis

Post-procedural pain remains a significant challenge following uterine artery embolisation (UAE) and intra-arterial lidocaine (IAL) has emerged as a potential adjunctive analgesic. This systematic review and meta-analysis evaluated the efficacy and safety of IAL during UAE. MEDLINE, Embase, and the Cochrane Library were searched from inception to June 2026, identifying eight studies including 692 patients. IAL significantly reduced pain at 4 h post-procedure and lowered the maximum pain experienced within the first 24 h. However, there were no significant differences in pain immediately after the procedure, at 7 or 24 h, opioid consumption, or inflammatory markers. Serious adverse events were uncommon. These findings suggest that IAL provides meaningful early pain relief and may serve as a safe adjunct in pain management for UAE. Systematic review registration PROSPERO CRD420261428710