DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20173082

Comparison between paracervical and intracervical block before procedures on uterine cavity and cervical dilatation

Jayaraman Nambiar M., Hema Prasanna Kurri, Muralidhar V. Pai

Abstract


Background: Procedures like dilatation and curettage and manual vacuum aspirations are one of the commonest procedures conducted in the outpatient Department of Obstetrics and Gynecology. Objective of present study was to find out whether intracervical block is as effective as paracervical block in patients undergoing cervical dilatation and procedures on uterine cavity.

Methods: Patients undergoing dilatation and curettage or manual vacuum aspiration were given either paracevrical block or intracervical block. The pain during cervical dilatation and curettage or manual vacuum aspiration were assessed on a 10 cm visual analogue scale.

Results: Mean visual analogue score during dilatation was comparable in both groups. Mean visual analogue score were comparable during dilatation in both groups before curettage or manual vacuum aspiration. Mean visual analogue scores during manual vacuum aspiration or curettage was also comparable with both groups. One patient had a serious side effect of convulsion during paracervical block.

Conclusions: Intracervical block is preferable to paracervical block during procedures like cervical dilatation and on procedures on uterine cavity as intracervical block requires less technical precision than paracervical block.


Keywords


Dilatation and curettage, Intracervical block, Manual vacuum aspiration, Paracervical block

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References


Centers for Disease Control. Abortion surveillance, United States, 2003. Available at: http://www.cdc.gov/mmwr/preview/ mmwrhtml/ss5511a1.htm. Retrieved March 18, 2009.

Bloom SL, Hauth JC, Gilstrap LC, III, Wenstrom KD, editors. Williams obstetrics. Obstetrical anesthesia. In: Cunningham FG, Leveno KJ. 22nd ed. New York (NY): McGraw-Hill;2005:479-80.

Lichtenberg ES, Paul M, Jones H. First trimester surgical abortion practices: a survey of National Abortion Federation members. Contraception 2001;64:345-52.

Grimmes DA, Cates W Jr. Deaths from paracervical anesthesia used for first trimester abortion. N Eng J Med. 1976;295:1397-9.

Thomas W, Strahan JD. Anesthesia or analgesia related deaths of women from legal abortion: The need for increased regulation. Assoc Interdiscip Res Values Social Change. 1997;12(1):1-2.

Renner RM, Nichols MD, Jensen JT, Li H, Edelman AB. Paracervical block for pain control in first trimester surgical abortion: A randomized control trial. Obstet Gynecol. 1974;118(8):1030-37.

Mankowski JL, Kingston J, Moran T, Nager CW, Lukacz ES. Lukacz. Paracervical compared with intracervical lidocaine for suction curettage. Obstet Gynecol. 2009;113(5):1052-7.

Wiebe ER, Rawling M. Pain control in abortion. Int J Gynecol Obstet. 1995;50:41-6.

Chanrachakul B, Likittanasombut P, O-Prasertsawat P, Herabutya Y. Lidocaine versus plain saline for pain relief in fractional curettage: a randomized controlled trial. Obstet Gynecol. 2001;98:592-5.

Khan AS, Ng EH, Ho PC. The role and comparison of two technique of paracervical block for pain relief during suction evacuation for the first trimester pregnancy termination. Contraception. 2004:70;159-163.