American Journal of Obstetrics & Gynecology
Volume 186, Issue 5, Supplement , Pages S127-S130, May 2002

Paracervical block for labor analgesia: A brief historic review☆

Departments of Anesthesia and Perioperative Care and Obstetrics, Gynecology and Reproductive Sciences, University of California-San Francisco. San Francisco, Calif

Abstract 

This historic review was written to clarify the known efficacy and side effects of paracervical blockade for labor analgesia. Although the popularity of the technique has diminished considerably, it continues to be used by some clinicians with ostensibly good results. The Cochrane Controlled Trials Register (CCTR;SR-PREG) and the electronic database MEDLINE were searched for studies reported in English to determine efficacy and side effects of paracervical block. Four randomized controlled studies specifically addressed paracervical block efficacy as assessed by parturients during labor with results of excellent or good analgesia among ~75%. Postparacervical block fetal bradycardia is the most significant side effect with a reported incidence ranging from 0% to ~40%. Overall, it appears that the incidence of postparacervical block fetal bradycardia is ~15%. However, the etiology of the observed fetal bradycardia remains unclear, and the incidence of adverse impact on fetal or neonatal outcome remains uncertain because there are too few trials with too few patients. (Am J Obstet Gynecol 2002;186:S127-30.)

Keywords:  Paracervical block, labor, analgesia

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☆ Reprints not available from author. Address correspondence to: Mark A. Rosen, MD, Professor of Anesthesia and Perioperative Care and Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143-0648. E-mail: rosenm@anesthesia.ucsf.edu

PII: S0002-9378(02)70187-7

American Journal of Obstetrics & Gynecology
Volume 186, Issue 5, Supplement , Pages S127-S130, May 2002

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