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Re: Obstetrical paracervical blockFrom: Arthurfree@aol.comSat Nov 22 10:29:12 1997
In a message dated 97-11-22 02:14:37 EST, you write: << I am a family physician practicing obstetrics and I have recently immigrated to the USA from Canada. I am currently being exposed to the use of paracervical blocks during labour, a technique I had not previously utilized. I would appreciate comments on the consensus of opinion in regards to this form of anaesthesia. I thankyou in advance.
Yours truly,
D. Crowther
>> Paracervical lidocaine was a reasonably effective method of first stage *analgesia* (block is imcomplete) and remains effective for other outpatient procedures in the non pregnant patient. It was abandoned in the early 80's (historically a time of skyrocketing liability insurance rates) as were many other reasonable treatments (this is when alphaprodine <Nisentil> was removed from the market because <gasp!> it was being used in labor - a process which appears to have a consistent side effect - litigation). The infrequent side effect of paracervical block, a prolonged severe decelleration lasting about ten minutes was very unnerving, but we never seemed to be fast enough to do more than oxygen, position change, and get the anesthetist out of bed! I am unaware (not researched) of any actual fetal injury associated with same. Keep in mind, this was when fetal monitoring was biblical in impact, it was not appreciated at the time how non-specific many heart rate changes were if they resembled those of asphyxiated chimpanzees at all! Arthur Freeland Warrensburg Missouri
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