Paracervical block for pain control in first-trimester surgical abortion: A randomized controlled trial

Regina Maria Renner, Mark D. Nichols, Jeffrey Jensen, Hong Li, Alison Edelman

Research output: Contribution to journalArticle

31 Scopus citations


OBJECTIVE:: Despite lack of efficacy data, the majority of first-trimester surgical abortions are performed with a paracervical block. Women may be unnecessarily exposed to a painful injection and potentially noxious medication. Our objective was to estimate the effect of a paracervical block and the effect of gestational age on patient pain perception. METHODS:: This was a randomized, single-blind trial of patients undergoing abortion receiving paracervical block or sham stratified by gestational age (early: less than 8 weeks of gestation, n=60; late: 8-10 6/7 weeks of gestation, n=60). Premedicated with ibuprofen and lorazepam, all participants received 2 mL 1% buffered lidocaine injected at the tenaculum site followed by a slow, deep injection of 18 mL at four sites (block) or no injection (sham) with a 3-minute wait. The primary outcome was dilation pain (100-mm visual analog scale). Secondary outcomes included pain at additional time points, satisfaction, need for more analgesics, and adverse events. RESULTS:: Full enrollment occurred (n=120). We used intent-to-treat analysis. Demographics did not differ between groups. Paracervical block administration was painful (mean 55 mm compared with sham 30 mm, P

Original languageEnglish (US)
Pages (from-to)1030-1037
Number of pages8
JournalObstetrics and Gynecology
Issue number5
Publication statusPublished - May 2012


ASJC Scopus subject areas

  • Obstetrics and Gynecology

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