ABSTRACT. Introduction

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MINISTRY OF EDUCATION AND SCIENCE OF RUSSIAN FEDERATION

Federal State Autonomous Educational Institution of Higher Education

«V. I. VERNADSKY CRIMEAN FEDERAL UNIVERSITY»

Medical Academy named after S. I. Georgievsky (structural subdivision).

ABSTRACT

SUBJECT : ____Paracervical block (OB& GYN)_______

STUDENT ____Shreyas Kishore Gujaran___________

(full name. )

faculty _____IMF-1__________ course ____4______ group _LA-1-CO-173(2)______

NAME OF PRACTICE: ___Акушерства, гинекологиии перинатологии №1___________________

SPECIALIZED ORGANIZATION _______Акушерства, гинекологиии перинатологии №1_____

CITY (urban village): _____Simferopol__________

DURATION OF PRACTICE: from___21/06_____till ____20/07_________2021_

Simferopol, 2017

Introduction

PARACERVICAL BLOCK anesthesia is being used more and more in this country. Numerous enthusiastic reports have appeared in various medical journals. This simple, safe and effective means of relieving pain eliminates the need for depressing amounts of analgesic drugs. No serious maternal or fetal complications have been reported. The principal use of paracervical block anesthesia is in relieving the pain of the first stage

of labor, where the relief it affords is quicker and greater than that produced by drugs which act on the central nervous system.

Neuroanatomy:

First stage labor pain is due mainly to dilatation of the cervix and to a lesser degree to uterine contractions. 3 The sensation of pain is due to impulses passing by sensory and sympathetic nerve pathways down the lateral and posterior portions of the cervix into the area of the uterosacral ligaments. The impulses travel through the uterine, pelvic and hypogastric plexuses into the lumbar and lower thoracic chain to the rami of the eleventh and twelfth thoracic nerves to reach the spinal cord. This route has been substantiated clinically by the complete relief of pain afforded when spinal, caudal, epidural, upper lumbar sympathetic, lower thoracic, paravertebral, uterosacral or paracervical block is used.

Pain of the second stage is produced primarily by distension of the lower birth canal, vulva and perineum and is conveyed by sensory pathways of the pudendal nerves, which enter the spinal cord via the posterior roots of the second, third and fourth sacral nerves. Paracervical block, therefore, is not sufficient for delivery.

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