Paracervical block with and without conscious sedation: a comparison of the pain levels during egg collection and the postoperative side effects

Objective: To compare the pain levels during egg collection and the subsequent postoperative side effects in patients receiving a paracervical block (PCB) with and without conscious sedation. Design: A prospective, randomized, double-blind, and placebo-controlled study. Setting: A tertiary assisted reproduction unit. Patient(s): 150 patients undergoing egg collection. Intervention(s): Randomized to receive PCB only (control group) and PCB in conjunction with conscious sedation (sedation group). Main Outcome Measure(s): Vaginal and abdominal pain levels; severity of postoperative side effects. Result(s): The median pain levels during vaginal punctures were 12.0 (2.5th-97.5th centiles: 0-84.3) and 30.0 (2.5th-97.5th centiles: 0-100) in the sedation and placebo groups, respectively, The corresponding median abdominal pain levels were 16.5 (2.5th-97.5th centiles: 0-100) and 43.0 (2.5th-97.5th centiles: 0-100). The pain levels were significantly higher in the placebo group than the sedation group. There were no significant differences between the two,groups in the severity of nausea, vomiting, dizziness, and drowsiness. Conclusion(s): Patients who received only a PCB during the egg collection experienced 2.5 times higher levels of vaginal and abdominal pain as compared to those who received both PCB and conscious sedation. The use of PCB along is not recommended for all patients but it may be considered with selected patients after they have been given extensive counseling. (C) 2001 by American Society for Reproductive Medicine.