Abstract :Objective: The study was conducted to compare the efficacy of three different paracervical blocks
used during dilatation and evacuation.
Study Design: This was a historical cohort study comparing three paracervical blocks using 4 units
of vasopressin alone (block A), 20 cc of 0.5% lidocaine with 4 units of vasopressin (block B) and
30 cc of 0.5% lidocaine with 6 units of vasopressin (block C). Primary outcome measures were the
length of procedure, quantity of intra-operative pain medications, post-operative pain scores and
post-operative recovery time. For assessment of post-operative pain scores a visual analog scale and/
or a 0-10 numeric pain scale was used.
Results: There were significant differences between post-operative pain score at 5, 10, and 15 mins
between block A and block B and C (P values of <0.001, <0.001 and <0.001 for block B vs. A and
0.052, 0.020 and 0.009 for block C vs. A). There was also a significant difference between the median
surgery times between the blocks (P-value of 0.0021). There was no significant difference in the total
recovery time between the blocks or intra-operative anesthesia given.
Conclusion: There was a significant difference in total operative time between block A and B/C.
There is a significant difference in post-operative pain score between blocks B/C and block A. No
significant difference in need for intra-operative anesthesia or recovery time.