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Related Concept Videos

Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

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Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

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Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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Paracervical Block for Laminaria Insertion Before Second-Trimester Abortion: A Randomized Controlled Trial.

Reni Soon1, Mary Tschann, Jennifer Salcedo

  • 1Department of Obstetrics, Gynecology & Women's Health and the Office of Biostatistics & Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii.

Obstetrics and Gynecology
|July 12, 2017
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Summary

A paracervical block significantly reduces pain during osmotic dilator insertion for second-trimester abortions. This procedure also enhances patient satisfaction with pain management during Laminaria placement.

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Area of Science:

  • Obstetrics and Gynecology
  • Pain Management
  • Surgical Procedures

Background:

  • Second-trimester abortions often involve osmotic dilator (Laminaria) insertion, a procedure that can cause significant pain.
  • Effective pain management during Laminaria insertion is crucial for patient comfort and satisfaction.

Purpose of the Study:

  • To evaluate the efficacy of a paracervical block in reducing pain associated with osmotic dilator insertion prior to second-trimester abortion.

Main Methods:

  • A double-blind, randomized trial involving 41 women undergoing Laminaria insertion for second-trimester abortion.
  • Participants received either a paracervical block with lidocaine and sodium bicarbonate or a sham block.
  • Pain was assessed using a 100-mm visual analog scale immediately after insertion and at other time points.

Main Results:

  • The paracervical block group reported significantly lower pain scores immediately after Laminaria insertion (13 mm vs. 54 mm, P=.01).
  • Women receiving the paracervical block also showed higher overall satisfaction with pain control during the procedure (95 mm vs. 70 mm, P=.05).

Conclusions:

  • A paracervical block is an effective method for reducing pain during Laminaria insertion for second-trimester abortions.
  • Utilizing a paracervical block improves overall patient satisfaction with pain management during this procedure.