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Paracervical block with 2-chloroprocaine.

R R Weiss, H G Nathanson, M R Tehrani

    Anesthesia and Analgesia
    |September 1, 1977
    PubMed
    Summary
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    Paracervical block with 2-chloroprocaine (2CP) provided effective pain relief for laboring women. This method demonstrated safety for both mother and fetus, though its short duration necessitated repeat procedures.

    Area of Science:

    • Obstetrics and Gynecology
    • Anesthesiology
    • Perinatal Medicine

    Background:

    • Pain management during labor is crucial for maternal well-being.
    • Paracervical block (PCB) is a regional anesthesia technique used in labor.
    • Ester-type local anesthetics are evaluated for their efficacy and safety in obstetric analgesia.

    Purpose of the Study:

    • To evaluate the efficacy and safety of 2-chloroprocaine (2CP) for paracervical block in term gravidas during active labor.
    • To assess maternal and fetal outcomes, including pain relief, duration of action, and potential adverse effects.

    Main Methods:

    • Thirty healthy term gravidas received paracervical block with 2-chloroprocaine.
    • Pain relief was assessed, and duration of action was recorded.

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  • Fetal heart rate, uterine contractions, and fetal scalp pH were monitored.
  • Neonatal status was evaluated using Apgar scores and cord blood acid-base analysis.

    • Main Results:

    • Excellent to good pain relief was achieved in 29 out of 30 women.
    • The mean duration of action was 38.9 minutes, with 6 women requiring repeat blocks.
    • Three cases of fetal bradycardia were observed, with only one definitively linked to the PCB.
    • No fetal acidosis, neonatal depression, or maternal complications were reported.

    Conclusions:

    • Paracervical block with 2-chloroprocaine is an effective, albeit short-acting, method for labor pain relief.
    • When administered with appropriate monitoring, 2CP paracervical block is safe for both mother and fetus.
    • The study highlights the need for monitoring due to the short duration of analgesia provided by 2CP.