Experience with mepivacaine paracervical block in an obstetric private practice.
OBJECTIVE
The objective of this study was to determine the efficacy and safety of mepivacaine paracervical block in term, low-risk obstetric patients.


METHODS
Over a 3-year period all term, low-risk obstetric patients in the author's private practice were offered mepivacaine paracervical block anesthesia. One hundred eighty-two patients received 200 mg mepivacaine with each block. The patients who declined paracervical block were used as a control group to compare Apgar scores, subject to chi 2 analysis.


RESULTS
Initial injections were 97.3% successful. Average duration of anesthesia was 59.7 minutes with the first injection. Fetal bradycardia occurred in 13.2% with an average duration of 4.5 minutes. The slightly higher incidence of low Apgar scores at 1 and 5 minutes in the study group was not statistically significant. One neonatal death occurred secondary to group B streptococcal sepsis in the study group.


CONCLUSIONS
Mepivacaine paracervical block remains an anesthetic option in low-risk patients. The high success rate is limited by its short duration of action and the incidence of fetal bradycardia.
Goins
J R
JR
D000773:Anesthesia, Obstetrical; D001034:Apgar Score; D005069:Evaluation Studies as Topic; D005260:Female; D005318:Fetal Heart / Q000187:drug effects; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000401:mortality; D007278:Injections, Spinal; D008619:Mepivacaine / Q000008:administration & dosage / Q000009:adverse effects; D009333:Neck; D009407:Nerve Block; D011014:Pneumonia / Q000401:mortality; D011247:Pregnancy; D013116:Spinal Cord
D008619:Mepivacaine