These pain control regimens include the paracervical block
, injection of local anaesthetics into the uterine cavity, paracetamol administration, non-steroidal anti-inflammatory drugs (NSAIDs), intravenous (IV) morphine, and avoiding the use of a tenaculum for endometrial sampling.
Jamshidi, "Paracervical block
with combined ketorolac and lidocaine in first-trimester surgical abortion: a randomized controlled trial," Obstetrics and Gynecology, vol.
Comparison of efficacy of oral drotaverine plus mefenamic acid with paracervical block
and with intravenous sedation for pain relief during hysteroscopy and endometrial biopsy.
Is it cost-effective to use a mucosal or paracervical block
to relieve the pain and cramping from cryosurgery?
(3,4) Renner and colleagues found that women who received a paracervical block
prior to MVA or EVA reported moderate levels of pain, according to a 100-point visual analogue scale (VAS), at the time of cervical dilation (mean, 42) and uterine aspiration (mean, 63).
(%) Number Receiving Analgesia Dosage(*) Excellent Good Paracervical block
1st dose 104 19 (18) 53 (51) 2nd dose 41 2 (5) 26 (63) 3rd dose 7 0 (0) 6 (86) Nalbuphine hydrochloride 1st dose 175 4 (2) 118 (67) 2nd dose 31 0 (0) 9 (29) Reported Pain Relief no.
A paracervical block
is performed and lidocaine jelly is placed in the cervix.
The majority of our hysteroscopic morcellations are done under conscious sedation with the addition of a local anesthetic in the form of a paracervical block
. A 200-mcg vaginal tablet of misoprostol (Cytotec) off label the night before surgery is the pretreatment strategy I most often employ for cervical preparation.
Concerns have been raised about the possibility of fetal bradycardia following paracervical block
, and there have been isolated reports of fetal or neonatal deaths attributed to the use of paracervical blocks
The purpose of this article is to recommend the use of mucosal block, paracervical block
, or no block on the basis of which procedure minimizes the costs of averting the pain and cramping that a woman experiences during cryosurgery.
Only 1 randomized controlled trial explored the use of anesthesia (versus placebo) during operative hysteroscopy, and the authors found a benefit for preprocedural paracervical block
using local anesthetic to reduce cervical pain.
-- Applying a paracervical block
before laparoscopic supracervical hysterectomy improves some operative outcomes but not others, Dr.