Journal article
Is paracervical block safe and effective? A prospective study of its association with neonatal umbilical artery pH values
The Journal of family practice, Vol.48(10), pp.778-784
10/1999
PMID: 12224675
Abstract
Paracervical blocks (PCBs) relieve labor pain, but reports of associated complications have caused many physicians to question their safety.
We designed a prospective observational study to examine the association between PCBs and umbilical artery hydrogen ion concentration (pH) values. A total of 261 healthy women in labor were recruited from a community hospital. Physicians used 1% lidocaine for the PCBs. We used multivariate linear regression to model predictors of umbilical artery pH at birth.
Of the women studied, 238 (91%) received analgesia during labor (nalbuphine, PCB, pudendal, caudal, or epidural). Of these, 126 (48%) received at least one PCB (191 were given), and 197 (76%) received at least one dose of nalbuphine (237 were given). Univariate analyses showed no significant differences in mean 1-minute Apgar scores, 5-minute Apgar scores, umbilical artery pH, resuscitation with oxygen by mask, or length of newborn stay according to either PCB or nalbuphine exposure. Factors significantly associated with lower umbilical artery pH in a linear regression analysis included longer second stage of labor (-0.032 pH units for each 1-hour increase; 95% confidence interval [CI], -.046 to -.018), pudendal block (-0.022; 95% CI, -.040 to -.004), intrauterine pressure catheter use (-0.029; 95% CI, -0.053 to -.006), nuchal cord (-0.027; 95% CI, -.051 to -.004), and midforceps delivery (-0.080; 95% CI, -.159 to .000). Increasing maternal age and induction with either artificial rupture of membranes or gel were associated with higher umbilical artery pH values.
After adjusting for other variables, neither PCB nor nalbuphine use were associated with umbilical artery pH at birth. PCBs using 1% lidocaine injected superficially should be considered a safe and effective form of obstetric analgesia. PCBs may be especially useful for women giving birth in hospitals where other obstetric anesthesia services are not readily available.
Details
- Title: Subtitle
- Is paracervical block safe and effective? A prospective study of its association with neonatal umbilical artery pH values
- Creators
- B T Levy - Department of Family Medicine, University of Iowa, Iowa City 52242, USA. barcey-levy@uiowa.eduG R BergusA HartzM LofgrenK Goldsborough
- Resource Type
- Journal article
- Publication Details
- The Journal of family practice, Vol.48(10), pp.778-784
- Publisher
- United States
- PMID
- 12224675
- ISSN
- 0094-3509
- eISSN
- 1533-7294
- Language
- English
- Date published
- 10/1999
- Academic Unit
- Physician Assistant Studies; Psychiatry; Epidemiology; Family and Community Medicine
- Record Identifier
- 9984025271402771
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