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Paracervical block

From Wikipedia, the free encyclopedia

Aparacervical block is ananesthetic procedure used inobstetrics and gynecology, in which alocal anesthetic is injected into between two and six sites at a depth of 3–7 mm alongside thevaginal portion of the cervix in thevaginal fornices.[1] In the United States, the paracervical block is underutilized during insertion ofintrauterine devices (IUDs). There is speculation that this is related to the disproportionate under-researching of women's health.[2]

It is used for various obstetric and gynecologic procedures, such ashysteroscopy andvacuum aspiration.It is as efficient asintracervical block, according to a study on women undergoingvacuum aspiration withlidocaine as anesthetic agent.[3]

The majority of surgical abortions in the United States are performed with a paracervical block with or without the addition of other pain medications. The best specific technique has yet to be defined and there is still a lot of procedure related pain.[4] The choice of the best anesthesia depends on patient preference and resources available.[4]

In addition, a paracervical block may be permormed by a wide variety of clinications including family medicine practitionor, advanced practitionors and RN's.[5]

Addition ofketorolac may offer added benefit of improved pain control.[6]

References

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  1. ^paracervical blockArchived 2011-07-28 at theWayback Machine By Robert Nadelberg. Copyright 2007 by Boston Scientific Corporation
  2. ^Murai, Ruth."Why haven't we figured out how to make IUDs less excruciating?".Mother Jones. Retrieved2023-01-18.
  3. ^Mankowski, J.; Kingston, J.; Moran, T.; Nager, C.; Lukacz, E. (2009). "Paracervical compared with intracervical lidocaine for suction curettage: a randomized controlled trial".Obstetrics and Gynecology.113 (5):1052–1057.doi:10.1097/AOG.0b013e31819ec97e.PMID 19384120.S2CID 25650472.
  4. ^abCrouthamel, Bonnie; Economou, Nicole; Averbach, Sarah; Rible, Radhika; Kully, Gennifer; Meckstroth, Karen; Mody, Sheila K. (August 2022)."Effect of Paracervical Block Volume on Pain Control for Dilation and Aspiration: A Randomized Controlled Trial".Obstetrics & Gynecology.140 (2):234–242.doi:10.1097/AOG.0000000000004862.ISSN 0029-7844.PMID 35852274.
  5. ^"Paracervical block".Ipas. Retrieved2024-04-15.
  6. ^Cansino, Catherine; Edelman, Alison; Burke, Anne; Jamshidi, Roxanne (December 2009)."Paracervical Block With Combined Ketorolac and Lidocaine in First-Trimester Surgical Abortion: A Randomized Controlled Trial".Obstetrics & Gynecology.114 (6):1220–1226.doi:10.1097/AOG.0b013e3181c1a55b.ISSN 0029-7844.PMID 19935022.S2CID 22458136.

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