{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T17:10:36Z","timestamp":1794071436471,"version":"4.8.0"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec>\n            <jats:title>OBJECTIVE:<\/jats:title>\n            <jats:p>To evaluate the efficacy of a paracervical block to decrease pain during osmotic dilator insertion before second-trimester abortion.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>In this double-blind, randomized trial, 41 women undergoing <jats:italic toggle=\"yes\">Laminaria<\/jats:italic> insertion before a second-trimester abortion received either a paracervical block with 18 mL 1% lidocaine and 2 mL sodium bicarbonate or a sham block. Women were between 14 and 23 6\/7 weeks of gestation. The primary outcome was pain immediately after insertion of <jats:italic toggle=\"yes\">Laminaria<\/jats:italic>. Women assessed their pain on a 100-mm visual analog scale. Secondary outcomes included assessment of pain at other times during the insertion procedure and overall satisfaction with pain control. To detect a 25-mm difference in pain immediately after <jats:italic toggle=\"yes\">Laminaria<\/jats:italic> insertion, at an \u03b1 of 0.05 and 80% power, we aimed to enroll 20 patients in each arm.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>From May 2015 to December 2015, 20 women received a paracervical block and 21 received a sham block. Groups were similar in demographics, including parity, history of surgical abortion, and number of <jats:italic toggle=\"yes\">Laminaria<\/jats:italic> placed. The paracervical block reduced pain after <jats:italic toggle=\"yes\">Laminaria<\/jats:italic> insertion (median scores 13 mm [interquartile range 2\u201339] compared with 54 mm [interquartile range 27\u201361], <jats:italic toggle=\"yes\">P<\/jats:italic>=.01, 95% CI \u221247.0 to \u22124.0). Women who received a paracervical block also reported higher satisfaction with overall pain control throughout the entire <jats:italic toggle=\"yes\">Laminaria<\/jats:italic> insertion procedure (median scores 95 mm [interquartile range 78\u2013100] compared with 70 mm [interquartile range 44\u201390], <jats:italic toggle=\"yes\">P<\/jats:italic>=.05, 95% CI 0.0\u201337.0).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION:<\/jats:title>\n            <jats:p>Paracervical block is effective at reducing the pain of <jats:italic toggle=\"yes\">Laminaria<\/jats:italic> insertion. Additionally, a paracervical block increases overall patient satisfaction with pain control during <jats:italic toggle=\"yes\">Laminaria<\/jats:italic> placement.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CLINICAL TRIAL REGISTRATION:<\/jats:title>\n            <jats:p>ClinicalTrials.gov, NCT02454296.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/aog.0000000000002149","type":"journal-article","created":{"date-parts":[[2017,7,11]],"date-time":"2017-07-11T14:41:44Z","timestamp":1499784104000},"page":"387-392","source":"Crossref","is-referenced-by-count":20,"title":["Paracervical Block for Laminaria Insertion Before Second-Trimester Abortion"],"prefix":"10.1097","volume":"130","author":[{"given":"Reni","family":"Soon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Tschann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Salcedo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katelyn","family":"Stevens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyeong Jun","family":"Ahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bliss","family":"Kaneshiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20230711","doi-asserted-by":"crossref","first-page":"2108","DOI":"10.1001\/jama.1984.03340400036021","article-title":"Prevention of uterine perforation during curettage abortion","volume":"251","author":"Grimes","year":"1984","journal-title":"JAMA"},{"key":"R2-20230711","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1097\/01.AOG.0000431056.79334.cc","article-title":"Second-trimester abortion. Practice Bulletin No. 135. American College of Obstetricians and Gynecologists","volume":"121","year":"2013","journal-title":"Obstet Gynecol"},{"key":"R4-20230711","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/j.contraception.2014.07.008","article-title":"Intrauterine lidocaine for pain control during laminaria insertion: a randomized controlled trial","volume":"90","author":"Mercier","year":"2014","journal-title":"Contraception"},{"key":"R5-20230711","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/j.contraception.2012.05.002","article-title":"Mifepristone vs. osmotic dilator insertion for cervical preparation prior to surgical abortion at 14\u201316 weeks: a randomized trial","volume":"86","author":"Borgatta","year":"2012","journal-title":"Contraception"},{"key":"R6-20230711","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1097\/01.AOG.0000168629.17326.00","article-title":"Misoprostol compared with laminaria before early second-trimester surgical abortion: a randomized trial","volume":"106","author":"Goldberg","year":"2005","journal-title":"Obstet Gynecol"},{"key":"R7-20230711","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.contraception.2014.11.014","article-title":"Adjunct mifepristone for cervical preparation prior to dilation and evacuation: a randomized trial","volume":"91","author":"Shaw","year":"2015","journal-title":"Contraception"},{"key":"R8-20230711","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.contraception.2007.07.008","article-title":"Mifepristone versus laminaria: a randomized controlled trial of cervical ripening in midtrimester termination","volume":"76","author":"Prairie","year":"2007","journal-title":"Contraception"},{"key":"R9-20230711","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1097\/AOG.0b013e318250b13e","article-title":"Paracervical block for pain control in first-trimester surgical abortion: a randomized controlled trial","volume":"119","author":"Renner","year":"2012","journal-title":"Obstet Gynecol"},{"key":"R10-20230711","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1016\/j.contraception.2012.06.004","article-title":"Pain control for intrauterine device insertion: a randomized trial of 1% lidocaine paracervical block","volume":"86","author":"Mody","year":"2012","journal-title":"Contraception"}],"container-title":["Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00006250-201708000-00019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T19:39:03Z","timestamp":1689104343000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00006250-201708000-00019"}},"subtitle":["A Randomized Controlled Trial"],"short-title":[],"issued":{"date-parts":[[2017,8]]},"references-count":9,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.1097\/aog.0000000000002149","relation":{},"ISSN":["0029-7844"],"issn-type":[{"value":"0029-7844","type":"print"}],"subject":[],"published":{"date-parts":[[2017,8]]}}}