A paracervical block is an anesthetic procedure used in obstetrics and gynecology, in which a local anesthetic is injected into between two and six sites at a depth of 3–7 mm alongside the vaginal portion of the cervix in the vaginal fornices.[1] In the United States, the paracervical block is underutilized during insertion of intrauterine 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 as hysteroscopy and vacuum aspiration. It is as efficient as intracervical block, according to a study on women undergoing vacuum aspiration with lidocaine 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 of ketorolac may offer added benefit of improved pain control.[6]
References
edit- ^ paracervical block Archived 2011-07-28 at the Wayback Machine By Robert Nadelberg. Copyright 2007 by Boston Scientific Corporation
- ^ Murai, Ruth. "Why haven't we figured out how to make IUDs less excruciating?". Mother Jones. Retrieved 2023-01-18.
- ^ 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.
- ^ a b Crouthamel, 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.
- ^ "Paracervical block". Ipas. Retrieved 2024-04-15.
- ^ 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.