[Paracervical block in obstetrics].
OBJECTIVE
To review the most recent and relevant issues concerning paracervical block in obstetrics since 1975 when Jägerhorn described the superficial technique that has become a standard.


METHODS
Extraction from Pubmed database of articles issued from 1975 to 2005.


METHODS
The collected articles were selected on the basis of the use of the superficial injection method. The more recent data were selected. The keywords were: paracervical, labour, childbirth, and neonate.


RESULTS
Paracervical block (PCB) is routinely used over the world despite the risk of foetal bradycardia. Bradycardia occurring immediately after the performance of block is short lasting. The reports of few cases of foetal or neonatal deaths have caused many physicians to question its safety. The incidence of bradycardia has dramatically decreased (less than 10%) due to the Jägerhorn superficial injection method. In case of healthy neonate the occurrence of bradycardia is harmless but its mechanism is still imprecise. The intensity an duration of analgesia is poor in comparison with epidural anaesthesia. PCB is a viable alternative to epidural in selected cases.
Sleth
J-C
JC
Service d'anesthésie-réanimation, polyclinique Saint-Roch, 43, rue du Faubourg-Saint-Jaumes, 34967 Montpellier cedex 02, France. jean-christian.sleth@wanadoo.fr <jean-christian.sleth@wanadoo.fr>
D002584:Cervix Uteri / Q000294:innervation*; D005260:Female; D005602:France; D006801:Humans; D009407:Nerve Block / Q000379:methods* / Q000706:statistics & numerical data / Q000639:trends; D009774:Obstetrics / Q000706:statistics & numerical data* / Q000639:trends; D011247:Pregnancy