[Critical evaluation of paracervical anaesthesia in obstetrics (personal observations in 8038 cases) (author's...

Between 1966 and 1973 a total of 8038 paracervical blockades (PCB) were performed at the Rhine State Women's Hospital in Wuppertal. In recent years the preparation normally used has been Bupivacain (Carbostesin) with adrenalin, 5 ml being injected paracervically. This results in complete analgesia in over 90% of cases. The incidence of forceps deliveries in the PCB group (19%) was higher, while the number of cesarean sections did not increase. Typical PCB-related bradycardias were observed in 6.9% of cases. Taking other forms of bradycardia into account-mainly reduced Dip II-a change in fetal cardiac action was seen in 12% of cases altogether. In 1973 there may have been a causal connection between PCB and postpartum infant death in 2 cases. In cases of acute bradycardia following PCB, intra-uterine reanimation, e.g. with Th 1165 a (Partutisten) under circulation control is recommended. Considering perinatal risks, especially those recognizable cardiotokodynagraphically, paracervical anesthesia is judged to be a suitable method of facilitating birth.