Canadian Journal of Anesthesia, Vol 14, 232-239, Copyright © 1967 by Canadian Anesthesiologists' Society

Paracervical Block Anaesthesia in Labour

¹ Woman's Hospital, St. Luke's Hospital Center, 114th Street & Amsterdam Avenue, New York, N.Y.

A series of 377 patients who received one or more paracervical blocks with 1 per cent mepivicaine during the first stage of labour has been reviewed. The duration of action of the block in the 208 primiparae was 31 to 120 minutes in 85 per cent and over 120 minutes in 5 per cent. In 169 multiparae, 89 per cent lasted 31 to 120 minutes and 1 per cent over 120 minutes. The results were good in 81 per cent of primiparae and 76 per cent of the multiparae. There were failures in 3 per cent of primiparae and 5 per cent of multiparae.

In the 39 infants with low one-minute Apgar scores, none of the low scores could be related to the paracervical block. Transient post-block foetal bradycardia of below 100 was noted in four patients (1.6%). This reaction, which has not been explained, did not represent foetal distress, but must be differentiated from it. There were no significant maternal or foetal complications secondary to paracervical block.

Despite the transient post-block decrease in uterine activity in 30 per cent of cases, there was no evidence that the paracervical block altered the length of labour or the rate of cervical dilation. Single-shot paracervical blocks proved to be a simple, safe, effective, easily taught, useful adjunct to achieving effective analgesia during the first stage of labour in uncomplicated pregnancies.

Note:

Dr. Povey's present address is: Population Council, Ford Foundation, 60 Av. Mohamed V, Tunis, Tunisia