paracervical block

A paracervical block is an anesthetic procedure used in obstetrics and gynecology, in which a local anesthetic is injected into between two and six sites at a depth of 3–7 mm alongside the vaginal portion of the cervix in the vaginal fornices.[http://www.bostonscientific.com/templatedata/imports/collateral/Gynecology/techspot_hta_anapharma.pdf paracervical block] {{webarchive|url=https://web.archive.org/web/20110728012028/http://www.bostonscientific.com/templatedata/imports/collateral/Gynecology/techspot_hta_anapharma.pdf |date=2011-07-28 }} By Robert Nadelberg. Copyright 2007 by Boston Scientific Corporation In the United States, the paracervical block is underutilized during insertion of intrauterine devices (IUDs). There is speculation that this is related to the disproportionate under-researching of women's health.{{Cite web |last=Murai |first=Ruth |title=Why haven't we figured out how to make IUDs less excruciating? |url=https://www.motherjones.com/politics/2022/06/why-are-iuds-so-painful-treatment-contraception-roe-dobbs-supreme-court/ |access-date=2023-01-18 |website=Mother Jones }}

It is used for various obstetric and gynecologic procedures, such as hysteroscopy and vacuum aspiration.

It is as efficient as intracervical block, according to a study on women undergoing vacuum aspiration with lidocaine as anesthetic agent.{{Cite journal

| last1 = Mankowski | first1 = J.

| last2 = Kingston | first2 = J.

| last3 = Moran | first3 = T.

| last4 = Nager | first4 = C.

| last5 = Lukacz | first5 = E.

| title = Paracervical compared with intracervical lidocaine for suction curettage: a randomized controlled trial

| journal = Obstetrics and Gynecology

| volume = 113

| issue = 5

| pages = 1052–1057

| year = 2009

| pmid = 19384120

| doi = 10.1097/AOG.0b013e31819ec97e

| s2cid = 25650472

}}

The majority of surgical abortions in the United States are performed with a paracervical block with or without the addition of other pain medications. The best specific technique has yet to be defined and there is still a lot of procedure related pain.{{Cite journal |last1=Crouthamel |first1=Bonnie |last2=Economou |first2=Nicole |last3=Averbach |first3=Sarah |last4=Rible |first4=Radhika |last5=Kully |first5=Gennifer |last6=Meckstroth |first6=Karen |last7=Mody |first7=Sheila K. |date=August 2022 |title=Effect of Paracervical Block Volume on Pain Control for Dilation and Aspiration: A Randomized Controlled Trial |url=https://journals.lww.com/10.1097/AOG.0000000000004862 |journal=Obstetrics & Gynecology |volume=140 |issue=2 |pages=234–242 |doi=10.1097/AOG.0000000000004862 |pmid=35852274 |issn=0029-7844|url-access=subscription }} The choice of the best anesthesia depends on patient preference and resources available.

In addition, a paracervical block may be permormed by a wide variety of clinications including family medicine practitionor, advanced practitionors and RN's.{{Cite web |title=Paracervical block |url=https://www.ipas.org/clinical-update/english/pain-management/paracervical-block/ |access-date=2024-04-15 |website=Ipas }}

Addition of ketorolac may offer added benefit of improved pain control.{{Cite journal|last1=Cansino|first1=Catherine|last2=Edelman|first2=Alison|last3=Burke|first3=Anne|last4=Jamshidi|first4=Roxanne|date=December 2009|title=Paracervical Block With Combined Ketorolac and Lidocaine in First-Trimester Surgical Abortion: A Randomized Controlled Trial|url=http://journals.lww.com/00006250-200912000-00010|journal=Obstetrics & Gynecology|volume=114|issue=6|pages=1220–1226|doi=10.1097/AOG.0b013e3181c1a55b|pmid=19935022|s2cid=22458136|issn=0029-7844|doi-access=|url-access=subscription}}