Background and Objectives Ischemic pain after uterine fibroid artery embolization (UFAE) is often severe. We evaluated the sensory anesthesia extent from thoracic epidural catheter test injection of lidocaine 75 mg with epinephrine 25 μg as a predictor of analgesia effectiveness after UFAE.

Methods One hundred patients were studied. Pinprick and cold insensitivity were assessed from L₃ to T₄ at 5-minute intervals for 30 minutes after the test dose. Thoracic epidural management was standardized. Total epidural infusate and numeric rating of pain (0–10) scores were recorded.

Results Pinprick or cold insensitivity at T₉ to T₁₀ dermatome was present in 94% of patients. Forty-six subjects (45%) achieved a sensory level at or above the T₆ dermatome at 30 minutes. Median analgesic consumption in the first hour and at catheter discontinuation was greater in subjects with a sensory level above T₆ compared with those below T₆: first hour difference, 7 mL (95% confidence interval [95% CI], 0–12 mL; P = 0.02); difference at discontinuation, 21 mL (95% CI, 4–35 mL; P = 0.02). The area under the pain score by time curve for the first 24 hours was greater in patients with sensory levels above T₆: difference 32 score · hour (95% CI, 12 score · h – 60 score · h; P = 0.001).

Conclusions Sensory anesthesia spread above the T₆ dermatome 30 minutes after a test dose of 1.5% lidocaine was an independent predictor of the analgesic consumption after UFAE. Pain burden and oral opioid consumption were also increased in subjects who demonstrated a high sensory spread after the test dose.