Paracervical block in obstetrics

Objective. -To review the most recent and relevant issues concerning paracervical block in obstetrics since 1975 when Jagerhorn described the superficial technique that has become a standard. Data sources. - Extraction from Pubmed((R)) database of articles issued from 1975 to 2005. Data selection. - 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. Data synthesis. - 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 Jagerhorn 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. (c) 2006 Elsevier Masson SAS. Tons droits reserves.