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November 4, 1968


JAMA. 1968;206(6):1187-1204. doi:10.1001/jama.1968.03150060007003

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Paracervical Block Safety Questioned  The long-standing assumption that paracervical block is a safe, preferred local anesthesia in childbirth has been challenged by findings of San Francisco investigators.A group at the University of California Medical Center determined that in some cases, fetuses of mothers given paracervical blocks with the drug, mepivacaine, develop bradycardia and receive high concentrations of the anesthetic.The group, headed by Sol M. Shnider, MD, recently reported its findings in two papers at the annual meeting of the American Society of Anesthesiologists, Washington, DC.The findings show, Dr. Shnider said, that fetal bradycardia is a much more serious development than many anesthesiologists have commonly believed.Seventeen healthy women in labor were given paracervical blocks with 20 ml of 1% mepivacaine. Maternal arterial blood samples were taken serially following the block, and fetal scalp blood samples were taken five to ten minutes following the block. Mepivacaine analyses