Assessment of Paracervical Nerve Block Anaesthesia during Labour

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Abstract
An assessment of paracervical nerve block anaesthesia was made in 118 women during labour using 0·5% bupivacaine with 1:200,000 parts of adrenaline added. The 82 multiparae were each given a single block and the 36 primigravidae a continuous block to try to provide the sole means of analgesia throughout the first stage of labour. Only 48% of the primigravidae required no other form of analgesia, as against 72% of the multiparae. Complications included a 17% incidence of maternal haemorrhage during insertion of the continuous needle, an overall fetal bradycardia rate of 11%, and two perinatal deaths following single paracervical block. It is concluded that the use of continuous paracervical block should be discontinued, and that amide-type local anaesthetic agents should not be used for single paracervical block.
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