Weiss R R, Nathanson H G, Tehrani M R, Tejani N A, Halevy S, Mann L I
Anesth Analg. 1977 Sep-Oct;56(5):709-16. doi: 10.1213/00000539-197709000-00020.
Thirty healthy term gravidas in active labor received a paracervical block (PCB) with the ester-type local anesthetic, 2-chloroprocaine (2CP). Good to excellent pain relief resulted in all but 1 case. The duration of action was short (mean 38.9 min), requiring repeat blocks in 6/30 cases. Fetal heart rate and uterine contractions were electronically monitored, and fetal acid-base status was periodically checked by fetal scalp pH measurements. PCB-related fetal bradycardia was observed in 3 cases, but in only 1 case was PCB the only cause for the bradycardia. Fetal acidosis was not observed. No instance of neonatal depression or acidosis as expressed by the 1- and 5-minute Apgar scores and cord blood acid-base evaluation was observed. No maternal complications were observed. It is concluded that paracervical block using 2CP is an effective though short-acting method of pain relief which, when properly monitored, is safe for both mother and fetus.
30名足月健康且处于活跃期分娩的孕妇接受了宫颈旁阻滞（PCB），使用酯类局部麻醉药2 - 氯普鲁卡因（2CP）。除1例患者外，其余患者疼痛缓解效果均为良好至极佳。作用持续时间较短（平均38.9分钟），30例中有6例需要重复阻滞。通过电子监测胎儿心率和子宫收缩情况，并定期通过胎儿头皮pH测量检查胎儿酸碱状态。观察到3例与PCB相关的胎儿心动过缓，但仅1例中PCB是心动过缓的唯一原因。未观察到胎儿酸中毒。未观察到新生儿抑郁或酸中毒的情况，这通过1分钟和5分钟阿氏评分以及脐血酸碱评估得以体现。未观察到母体并发症。结论是，使用2CP进行宫颈旁阻滞是一种有效的镇痛方法，尽管作用时间较短，但在适当监测下对母亲和胎儿都是安全的。
