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Comparison of paracervical block techniques during first trimester pregnancy termination
Author(s) -
Glantz J.C.,
Shomento S.
Publication year - 2001
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/s0020-7292(00)00292-7
Subject(s) - paracervical block , medicine , saline , anesthesia , obstetrics , abortion , isotonic saline , pregnancy , lidocaine , biology , genetics
Objectives : To determine whether variations in chloroprocaine placement in paracervical blocks influence effectiveness, whether chloroprocaine is superior to saline, and what factors influence pain perception. Method : Eighty‐two women undergoing first trimester aspiration abortions were randomized to receive 1% chloroprocaine or saline at 3–5–7–9 or 4–8 o'clock positions. Using a 0–10 scale, women rated anxiety, dysmenorrhea, and pain associated with laminaria insertion, paracervical block, and aspiration. Results : All four groups were similar in medical and demographic characteristics. Injection position did not influence pain ratings, but women who received chloroprocaine had less pain than those who received saline (6.3±2.3 vs. 7.8±2.0, P =0.002). Paracervical pain and dysmenorrhea were independently associated with aspiration pain scores (respective regression coefficients 0.49 and 0.26, P <0.008). Conclusions : There is no advantage to using a four‐site paracervical block over a two‐site technique, but chloroprocaine is superior to saline. Paracervical block may not provide adequate anesthesia during first trimester abortion, especially for women with significant dysmenorrhea.