A comparative study was conducted to evaluate the effects of repeated, longacting
paracervical blocks on the abortifacient efficacy of intraamniotic
prostaglandin F2alpha (PGF2alpha)-40 mg initially and an additional 20 mg after 24 hours--and hypertonic saline augmented with intravenous
oxytocin, for patients at 16 to 20 weeks' gestation. Patients were randomly assigned to the 2 abortion procedures, and one half (50) of the patients induced with each procedure received serial, longacting
paracervical blocks. For those patients aborted with saline, the rates of complications, side effects,
incomplete abortion, and cumulative abortion were similar for patients whether they did or did not receive
paracervical blocks. Among the PGF2alpha-treated patients who were administered
paracervical blocks, there was a significant reduction in the rates of gastrointestinal side effects and
incomplete abortion and a significant differences in the cumulative
abortion rates. Within 32 hours of the initial
PGF2alpha, instillation, 98% of the patients who received
paracervical blocks aborted compared to 70% of those who did not receive
paracervical blocks. Although the cumulative
abortion rates of PGF2alpha-treated patients with
paracervical blocks and saline-treated patients were similar, the rate of
incomplete abortion for the PGF2alpha-treated patients was significantly lower. Additional studies will be necessary to evaluate the safety and advantages of using
paracervical block anesthesia as an adjunct to midtrimester abortion procedures.