paracervical block for evacuation of retained products of conception effective?

ABSTRACT

Complications from general anaesthesia are now the leading cause of death from first trimester abortions. Although paracervical block has been instituted as an alternative for general anaesthesia for ERPC [evacuation of retained products of conception]. Almost all cases in Egypt are still currently done under general anaesthesia. The objective of this study was to quantitate pain relief associated with paracervical local anaesthesia during ERPC. Among 48 patients who underwent the procedure under paracervical block, 11 patients [22.9%] reported grade 1 pain [minimal discomfort], 23 patients [47.9%] grade 2 pain [mild pain but not uncomfortable] and 9 patients [18.7%] needed extradoses of intravenous sedation [diazepam/pethidine]. Only 5 patients [10.4%] could not cope with the pain and needed general anesthesia to complete the procedure. 81% of the patients were generally satisfied with the procedure. Pain score tended to decrease with lower body weight and higher parity, older age and shorter duration of the procedure. In conclusion, local paracervical block is a simple safe and effective option for ERPC operation and should replace general anaesthesia in all but few cases