“Para Cervical Block For Cervical Dilatation And Uterine Evacuation By MVA Method: A Safe And Effective Alternative At Tertiary Care,Teaching Hospital.”
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 5
Abstract
Objectives :To Determine the safety and effectiveness of Para-cervical Block for cervical dilatation and uterine evacuation by MVA method for patients, who are at high risk for developing general anesthesia related complications. Materials & Methods: This descriptive (cross sectional) study was conducted at tertiary care center between September 2017 to February 2018. Total 212 patients had undergone MVA procedure for First trimester incomplete abortion of 12 weeks gestation or less than it. Among them, 162 patients received general anesthesia and remaining, 50 patients received para cervical block. All those 50 patients were counselled regarding MVA procedure under para cervical block. Preoperatively, all patients were given Injection Diclofenac sodium and Injection Atropine Intra-muscularly. All the patients were asked to evaluate the level of pain on a visual analog scale ranged from 0-10. Three minutes after application of para-cervical block, suction and evacuation of uterus by MVA method done. Thirty minutes after the procedure, all patients were asked to describe the pain that they felt during MVA procedure by using the same visual analog scale. Visual analog scale was described by : No pain (o point), slight pain (1-3 points), Moderate pain (4-6 points), severe pain (7-10 points). All patients were followed up after a week, evaluated for complications and a routine USG of abdomen & pelvis was done, which revealed completeness of the procedure. Results: All were first trimester incomplete abortion cases. MVA was performed with para cervical block. According to VAS, 33 (60%) patients had mild pain, 04 (08%) patients had moderate pain, 13(26%) patients had no pain during the procedure. Seven (14%) patients had mild pain and others had no pain after the procedure. There was no severe pain before or after the procedure. No patients had any complications like excessive bleeding, infection or retained products of conception. Thirty Nine (78%) patients were discharged within 24 hours and eleven (22%) patients were discharged after 24 hours with medical advises for associated co-morbodities. Hospital stay and utilization of hospital reserves were reduced and patients satisfaction was equally good. Conclusion : Para cervical block is safe and effective option during MVA procedure for patients who are at high risk for developing general anesthesia related complications.
Authors and Affiliations
Dr. Arti Jayesh Patel, Dr. Divyesh Arvind Thakkar
Keywords
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- EP ID EP374385
- DOI 10.9790/0853-1705041619.
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